Individual
DR. KELLY ANNE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
14645 SW FARMINGTON RD, BEAVERTON, OR 97007-2727
(503) 643-8626
Mailing address
11761 NW BLACKHAWK DR, PORTLAND, OR 97229-8807
(503) 778-0551
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
391117
OR
Other
Enumeration date
09/22/2017
Last updated
04/02/2018
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