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Contact Information

IAN J MOORE, PEER SUPPORT SPECIAL
1911 HAZEL AVE
MEDFORD, OR97501
 Phone: 541-734-3951
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Specialist

174400000X
 

Case Manager/Care Coordinator

171M00000X
Indicates primary specialty

NPI Profile & details for IAN J MOORE · (Male)

NPI Number 1861762809
Status Active
Credentials PEER SUPPORT SPECIAL
Entity Individual
Enumeration date 01/09/2012
Last updated 01/09/2012 - About 14 years ago
Sole proprietor 1 No
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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