Individual
LAUREL ALYSE MOSSOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QMHA
Contact information
Practice address
1818 SE DIVISION ST, PORTLAND, OR 97202-1159
(503) 238-0705
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/24/2018
Last updated
07/06/2020
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