Individual
ARCHIE LEE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2270 NW OVERTON ST, PORTLAND, OR 97210-2927
(503) 241-6051
(503) 222-1357
Mailing address
10594 SE CHERRY BLOSSOM DR, PORTLAND, OR 97216-2845
(503) 241-6051
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/30/2007
Last updated
07/08/2007
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