Individual
SHELA RENEE MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1116 14TH AVE, LONGVIEW, WA 98632-3017
(360) 261-6930
Mailing address
1116 14TH AVE, LONGVIEW, WA 98632-3017
(360) 261-6930
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
201041551RN
OR
163WP0808X
Psychiatric/Mental Health Registered Nurse
RN61050614
WA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
10024830
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP61548893
WA
Other
Enumeration date
10/04/2023
Last updated
06/05/2024
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