Individual
DR. LOUIS HENRICH MOORE III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
2103 NE SARATOGA ST, PORTLAND, OR 97211-5240
(503) 568-1352
Mailing address
2103 NE SARATOGA ST, PORTLAND, OR 97211-5240
(503) 568-1352
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
6351004389
MI
103TC0700X
Clinical Psychologist
Primary
3611
OR
103TC0700X
Clinical Psychologist
6351004389APP21
MI
Other
Enumeration date
07/30/2021
Last updated
01/28/2026
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