Individual
DEIDRE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
349 NW 14TH ST, MCMINNVILLE, OR 97128-2901
(971) 241-8256
Mailing address
349 NW 14TH ST, MCMINNVILLE, OR 97128-2901
(971) 241-8256
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
04/06/2017
Last updated
04/06/2017
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