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Individual
RYAN PATRICK MOORE
Active
Individual
RYAN PATRICK MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
OA60803041
WA
363AS0400X
Surgical Physician Assistant
PA.0777859
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2096256
—
WA
Enumeration date
10/17/2017
Last updated
12/07/2020
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