Individual provider · Type 1 NPI

Lola Diane Moore, RN, MN, PMHNP

Psychiatric/Mental Health Nurse Practitioner · Milwaukie, OR

NPI number 1912143397 Active

Practice location

17714 SE Addie St Apt B
Milwaukie, OR 97267-6148

Call (503) 659-2244 Map

Mailing address

295 Amanda Ct
Oregon City, OR 97045-3467

Specialties and licenses

TaxonomyCodeLicense
Registered Nurse 163W00000X095000161RN (OR)
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808X200950098NP (OR)

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

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About NPI 1912143397

Lola Diane Moore, RN, MN, PMHNP's National Provider Identifier is 1912143397, issued on Jan 6, 2009. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Milwaukie, OR. The record was last updated on Mar 3, 2014.