Individual
CARY C MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
3300 PROVIDENCE DR STE B302, ANCHORAGE, AK 99508-4621
(907) 212-2090
(907) 212-2570
Mailing address
PO BOX 4105, PORTLAND, OR 97208-4105
(866) 907-1068
(425) 917-9141
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
PHYO2060
AK
261QX0100X
Occupational Medicine Clinic/Center
2060
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CMG121
—
AK
05
—
HC1621
—
AK
Enumeration date
07/24/2009
Last updated
08/23/2021
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