Individual
KATHLEEN P MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
1637 S MARKET BLVD, CHEHALIS, WA 98532-3826
(360) 748-9827
(360) 748-7353
Mailing address
2142 JACKSON HWY, CHEHALIS, WA 98532-4410
(360) 748-0355
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00021313
WA
Other
Enumeration date
04/30/2007
Last updated
07/08/2007
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