Individual
DENNIS MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1003 WALLACE WAY, GRANDVIEW, WA 98930-8805
(509) 203-1080
(509) 203-1077
Mailing address
1003 WALLACE WAY, GRANDVIEW, WA 98930-8805
(509) 203-1080
(509) 203-1077
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
9907
NV
208000000X
Pediatrics Physician
Primary
MD61499857
WA
2080A0000X
Pediatric Adolescent Medicine Physician
NV 9907
NV
Other
Enumeration date
02/09/2007
Last updated
08/01/2024
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