Individual
CASSANDRA JO MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1720 NW LOVEJOY ST, PORTLAND, OR 97209-2346
(503) 379-0773
Mailing address
10730 NE TILLAMOOK ST, PORTLAND, OR 97220-3767
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
R4698
OR
Other
Enumeration date
08/18/2017
Last updated
08/18/2017
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