Individual
MS. PATRICIA KENNEY-MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, PA-C
Contact information
Practice address
19250 SW 65TH AVE, SUITE 110, TUALATIN, OR 97062-7452
(503) 692-1205
Mailing address
24979 NE PRAIRIE VIEW DR, AURORA, OR 97002-9547
(503) 678-5921
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00606
OR
Other
Enumeration date
05/18/2007
Last updated
07/08/2007
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