Individual
SAMANTHA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
500 LILLY RD NE, OLYMPIA, WA 98506-5195
(360) 413-8250
Mailing address
500 LILLY RD NE, OLYMPIA, WA 98506-5195
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
60671181
WA
Other
Enumeration date
05/07/2016
Last updated
10/24/2016
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