Individual
KRISTIN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3303 SW BOND AVE, PORTLAND, OR 97239-4501
(503) 494-3151
Mailing address
3303 SW BOND AVE, PORTLAND, OR 97239-4501
(503) 494-3151
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
61415
OR
2251N0400X
Neurology Physical Therapist
61415
OR
2251P0200X
Pediatric Physical Therapist
61415
OR
2251S0007X
Sports Physical Therapist
61415
OR
2251X0800X
Orthopedic Physical Therapist
Primary
61415
OR
Other
Enumeration date
04/09/2020
Last updated
04/09/2020
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