Individual
ELLEN MOONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1535 N WILLIAMS AVE, PORTLAND, OR 97227-1885
(503) 238-2067
Mailing address
1535 N WILLIAMS AVE, PORTLAND, OR 97227-1885
(503) 238-2067
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
DO197830
OR
Other
Enumeration date
06/05/2016
Last updated
01/11/2022
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