Individual
MONIREH MICHELLE MOGHADAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3710 SW US VETERANS HOSPITAL RD, P3MHDC, PORTLAND, OR 97239-2964
(503) 220-8262
Mailing address
3710 SW US VETERANS HOSPITAL RD, P3MHDC, PORTLAND, OR 97239-2964
(503) 220-8262
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L4501
OR
1041C0700X
Clinical Social Worker
LCS20475
CA
Other
Enumeration date
06/29/2007
Last updated
07/06/2013
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