STACEY L S MOORE

GRESHAM, OR
NPI1558426593
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy225X00000X Occupational Therapist
(Licence: OR  1073412)
Additional Taxonomies225X00000X Occupational Therapist
(Licence: PA  OC-009631)
Enumeration Date2006-12-27
Last Update Date2023-09-19
Business Address
Mrs. STACEY L S MOORE MOTR/L
2895 SE POWELL VALLEY RD
GRESHAM, OR 97080-1492
Phone number: 971-571-5319
Mailing Address
Mrs. STACEY L S MOORE MOTR/L
12806 NE SAN RAFAEL ST
PORTLAND, OR 97230-1826
Phone number: