Individual
DR. KATHLEEN R MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1303 NE CUSHING DR STE 100, BEND, OR 97701
(541) 388-2333
(541) 388-0930
Mailing address
1303 NE CUSHING DR, SUITE 100, BEND, OR 97701-3887
(541) 388-2333
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
MD19840
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
079954
—
OR
01
—
200026305
RAILROAD MEDICARE
OR
Enumeration date
02/07/2006
Last updated
09/11/2018
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