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Individual

MS. TAMMY H. MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
600 E. MAIN STREET, ELMA, WA 98541
(360) 495-3244
(360) 495-3364
Mailing address
600 E. MAIN STREET, ELMA, WA 98541
(360) 495-3244
(360) 495-3364

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
AP30006758
WA
363LP2300X
Primary Care Nurse Practitioner
Primary
AP30006758
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0159113
LABOR AND INDUSTRIES#
WA
05
1090710
WA
01
9644014
DSHS#
WA
Enumeration date
06/29/2006
Last updated
03/07/2023
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