Individual
MR. MICHAEL DONALD MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MOT
Contact information
Practice address
4560 SE INTERNATIONAL WAY, CONSONUS HEALTHCARE SERVICES SUITE 100, MILWAUKIE, OR 97200
(971) 206-5149
(971) 206-5209
Mailing address
4560 SE INTERNATIONAL WAY, CONSONUS HEALTHCARE SERVICES SUITE 100, MILWAUKIE, OR 97200
(971) 206-5149
(971) 206-5209
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT00002754
WA
Other
Enumeration date
10/23/2007
Last updated
10/23/2007
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