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Individual
MELODY LYNN MOORE
Active
Individual
MELODY LYNN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
61505595
WA
1041C0700X
Clinical Social Worker
C006993
NC
363A00000X
Physician Assistant
0010-13458
NC
363A00000X
Physician Assistant
Primary
61505595
WA
Other
Enumeration date
09/23/2010
Last updated
11/18/2025
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