Most Relevant Information
Provider Data
| NPI Number: | 1003519307 |
| Provider Name: | KATIE MARIKA MOON |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/24/2023 |
| Last Updated: | 03/24/2023 |
Provider Practice Location
702 JOHN ADAMS ST
OREGON CITY
OR
970451955
Practice Location Phone/Fax
| Phone: | 5037301469 |
| Fax: |
Provider Mailing Location
PO BOX 3973
TUALATIN
OR
970623973
Provider Mailing Phone/Fax
| Phone: | 5037301469 |
| Fax: |