Individual
MEREDITH MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
825 NE 20TH AVE STE 250, PORTLAND, OR 97232-2282
(503) 917-5737
(503) 809-2021
Mailing address
825 NE 20TH AVE STE 250, PORTLAND, OR 97232-2282
(503) 917-5737
(503) 809-2021
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
03/07/2022
Last updated
01/17/2025
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