Individual
ILEANA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
407 N COAST HWY STE 300, NEWPORT, OR 97365-3117
(503) 390-5637
(541) 264-7515
Mailing address
407 N COAST HWY STE 300, NEWPORT, OR 97365-3117
(503) 390-5637
(541) 264-7515
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/30/2021
Last updated
10/30/2021
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