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Lilyan Charlotte Russel Smith-moore, MED
Mental Health Counselor in Portland, Oregon
NPI 1205378858

Lilyan Charlotte Russel Smith-moore is a Mental Health Counselor based in Portland, OR and is specialized in Mental Health. Lilyan Charlotte Russel Smith-moore practices in Portland, OR and has the professional credentials of MED. The NPI Number for Lilyan Charlotte Russel Smith-moore is 1205378858 and holds a License No. C4955 (Oregon).

The current practice location address for Lilyan Charlotte Russel Smith-moore is 101 Sw Madison St., Portland, OR and can be reached out via phone at 971-373-4497.

Location: 101 Sw Madison St., Portland, OR, 97207-9152
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Provider Profile Details
NPI Number
1205378858
Provider Name
Lilyan Charlotte Russel Smith-moore
Credential
MED
Provider Entity Type
Individual
Gender
Female
Address
101 Sw Madison St., Portland, OR, 97207-9152
Phone Number
971-373-4497
Fax Number
Provider Enumeration Date
11/14/2016
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
500725324 05 OR
institution
Provider Business Practice Location Address Details
Address
101 Sw Madison St.
City
State
Zip
97204-3264
Phone Number
971-373-4497
Fax Number
person
Provider Business Mailing Address Details
Address
101 Sw Madison St.
City
State
Zip
97204-3264
Phone Number
971-373-4497
Fax Number
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Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
C4955 (Oregon)
Definition
Definition to come...
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