Individual
DR. JONATHAN TAD MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
9600 VETERANS DR SW, 116-A, TACOMA, WA 98493-0003
(253) 583-1771
Mailing address
9600 VETERANS DR SW, 116-A, TACOMA, WA 98493-0003
(253) 583-1771
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY 60586639
WA
Other
Enumeration date
06/22/2010
Last updated
01/25/2016
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