Individual
CARL MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDP
Contact information
Practice address
1901 MLK JR WAY S, SEATTLE, WA 98144-4801
(206) 322-7676
(206) 726-7585
Mailing address
3629 S D ST, TACOMA, WA 98418-6813
(253) 798-6572
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP 00006161
WA
Other
Enumeration date
04/05/2012
Last updated
02/01/2019
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