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Organization

TRIPLE MOON THERAPY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. COURTNEY LIVAUDAIS OTD, OTR/L (OWNER)
(503) 549-1103
Entity
Organization

Contact information

Practice address
5751 N VANCOUVER AVE, PORTLAND, OR 97217-2450
(503) 549-1103
Mailing address
PO BOX 1111, PORTLAND, OR 97207-1111

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary

Other

Enumeration date
12/15/2022
Last updated
12/15/2022
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