Individual
MRS. LISA LEAH MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDP
Contact information
Practice address
2280 SR 821, SELAH, WA 98901
(509) 457-0990
(509) 454-4548
Mailing address
2280 SR 821, SELAH, WA 98901
(509) 457-0990
(509) 454-4548
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP00000778
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CP00000778
CDP
WA
Enumeration date
11/01/2018
Last updated
11/01/2018
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