# JACQUELINE MOORE PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Jacqueline Moore PLLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093602906
- **Authorized official:** JACQUELINE MARIE MOORE MSN, ARNP, PMHNP-BC (OWNER/PROVIDER)
- **Authorized official phone:** (360) 322-4711

## Contact information

- **Practice address:** 701 NE 136TH AVE STE 200, VANCOUVER, WA 98684-6937
- **Practice address phone:** (360) 322-4711
- **Practice address fax:** (360) 583-6404
- **Mailing address:** 701 NE 136TH AVE STE 200, VANCOUVER, WA 98684-6937
- **Mailing address phone:** (360) 322-4711
- **Mailing address fax:** (360) 583-6404

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 06/23/2025
- **Last updated:** 06/23/2025