Individual
CASEY D MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7487 GLADSTONE AVE, WHITE CITY, OR 97503-1703
(541) 778-7265
Mailing address
7487 GLADSTONE AVE, WHITE CITY, OR 97503-1703
(541) 778-7265
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
104489
OR
Other
Enumeration date
09/30/2025
Last updated
09/30/2025
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