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Individual

PATRICK J MORAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
1631 SW COLUMBIA ST, PORTLAND, OR 97201-6025
(503) 231-2641
(503) 231-1654
Mailing address
1776 SW MADISON ST, PORTLAND, OR 97205-1715
(503) 224-1044
(503) 224-4494

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1450
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500640072
OR
Enumeration date
11/02/2005
Last updated
03/27/2017
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