Individual
KATIE EMILY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AAS, CDPT
Contact information
Practice address
11910 NE 154TH ST, BRUSH PRAIRIE, WA 98606-9571
(360) 750-9588
Mailing address
21917 NE 209TH AVE, BATTLE GROUND, WA 98604-4920
(360) 524-5703
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60779419
WA
Other
Enumeration date
10/05/2018
Last updated
10/05/2018
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