Individual
MS. MARY MARGARET MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDP
Contact information
Practice address
1601 E FOURTH PLAIN BLVD, BLDG 17, STE 222, VANCOUVER, WA 98661-3753
(360) 397-8488
(360) 397-8494
Mailing address
PO BOX 1845, VANCOUVER, WA 98668-1845
(360) 397-8488
(360) 397-8494
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP00002617
WA
Other
Enumeration date
03/28/2010
Last updated
03/28/2010
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