Individual
JULIEANNA ROSE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
2006 MAIN ST, VANCOUVER, WA 98660-2637
(360) 906-0826
Mailing address
4317 NE 66TH AVE, APT J92, VANCOUVER, WA 98661-3081
(360) 213-3888
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA 60212942
WA
Other
Enumeration date
09/21/2011
Last updated
09/21/2011
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