Individual
DERRICK MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
14819 E MISSION AVE, SPOKANE VALLEY, WA 99216-1960
(509) 315-9791
(509) 474-9612
Mailing address
14819 E MISSION AVE, SPOKANE VALLEY, WA 99216-1960
(509) 315-9791
(509) 474-9612
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/19/2021
Last updated
02/19/2021
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