Provider Demographics
NPI:1538347653
Name:MOYELL, JOHN ANDREW (QHMP-MSW)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:ANDREW
Last Name:MOYELL
Suffix:
Gender:M
Credentials:QHMP-MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2344 N SCHOFIELD ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97217-6830
Mailing Address - Country:US
Mailing Address - Phone:503-539-7717
Mailing Address - Fax:
Practice Address - Street 1:58646 MCNULTY WAY
Practice Address - Street 2:
Practice Address - City:SAINT HELENS
Practice Address - State:OR
Practice Address - Zip Code:97051-6210
Practice Address - Country:US
Practice Address - Phone:503-397-6900
Practice Address - Fax:503-397-6818
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-31
Last Update Date:2010-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor