Individual
MR. SHERWIN H. MOSCOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
1550 NW EASTMAN PKWY, GRESHAM, OR 97030-3858
(503) 571-0725
(503) 571-0720
Mailing address
5264 NE 121ST AVE APT 315, VANCOUVER, WA 98682-2160
(360) 828-5844
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CP00005723
WA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
OR88-09-01
OR
Other
Enumeration date
08/16/2006
Last updated
07/08/2007
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