Individual
PAMELA RAYE MOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
2004 BROADWAY ST, VANCOUVER, WA 98663-3327
(360) 993-8868
Mailing address
2004 BROADWAY ST, VANCOUVER, WA 98663-3327
(360) 993-8868
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00013246
WA
Other
Enumeration date
09/04/2008
Last updated
09/04/2008
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