MEDICARE: PATRICIA ROHANI-MOAYED LPC, LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	C2951	OR
2	106H00000X	Marriage & Family Therapist	T0871	OR

General Provider Information

NPI Number	:	1528294808
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA ROHANI-MOAYED LPC, LMFT

Provider Business Mailing Address
First Line	:	702 JOHN ADAMS ST STE 201
Second Line	:
City	:	OREGON CITY
State	:	OR
Zip	:	97045-1955
Country	:	US
Telephone Number	:	503-896-6796
Fax Number	:

Provider Business Practice Location Address
First Line	:	702 JOHN ADAMS ST ST STE 201
Second Line	:
City	:	OREGON CITY
State	:	OR
Zip	:	97045-2246
Country	:	US
Telephone Number	:	503-896-6796
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2009
Last Update Date	:	06/02/2014

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