Individual
JILLIAN MARGUERITE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRM
Contact information
Practice address
200 SE HAILEY AVE STE 204, PENDLETON, OR 97801-3072
(541) 663-4104
(541) 663-4142
Mailing address
1275 W MADRONA AVE APT B, HERMISTON, OR 97838-1445
(541) 314-5570
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
T-25-5204
OR
175T00000X
Peer Specialist
Primary
25-CRM-4289
OR
251S00000X
Community/Behavioral Health Agency
Primary
25-CRM-4289
OR
Other
Enumeration date
08/07/2025
Last updated
01/22/2026
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