Individual
AMANDA M MOONEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3180 CENTER ST NE, SALEM, OR 97301-4532
(503) 585-4949
Mailing address
3180 CENTER ST NE, SALEM, OR 97301-4532
(503) 585-4949
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
93-6002307
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
122994
—
OR
Enumeration date
10/31/2023
Last updated
10/31/2023
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