Individual
JAMIANNE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4713 N ALBINA AVE UNIT 301, PORTLAND, OR 97217-2605
(503) 850-2474
Mailing address
700 NE 87TH AVE, VANCOUVER, WA 98664-4896
(360) 882-2778
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
7390
AZ
363A00000X
Physician Assistant
Primary
PA218023
OR
363A00000X
Physician Assistant
PA61309256
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2211352
—
WA
Enumeration date
01/03/2019
Last updated
06/23/2025
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