Individual provider · Type 1 NPI

Cotrell Moore

Mental Health Counselor · Portland, OR

NPI number 1679013601 Active

Practice location

7759 SE 72nd Ave
Portland, OR 97206-7921

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

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About NPI 1679013601

Cotrell Moore's National Provider Identifier is 1679013601, issued on Feb 23, 2017. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Portland, OR. The record was last updated on Oct 7, 2026.