Individual
MADELINE ROSE MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC-R
Contact information
Practice address
324 NW DAVIS ST, PORTLAND, OR 97209-3925
(503) 226-2203
Mailing address
324 NW DAVIS ST, PORTLAND, OR 97209-3925
(503) 226-2203
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-23-3214
OR
Other
Enumeration date
11/03/2023
Last updated
11/03/2023
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