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Individual
ROBIN R MOORE
Active
Individual
ROBIN R MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10004528
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039581
LABOR AND INDUSTRIES #
WA
01
—
2681MO
BLUE SHIELD #
WA
05
—
8371296
—
WA
01
—
P00265426
RAILROAD MC#
WA
01
—
US7195615
AETNA SPECIALIST PIN
WA
Enumeration date
11/06/2006
Last updated
04/27/2021
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