Individual
KIMBERLY MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1420 STATE ROUTE 20, SEDRO WOOLLEY, WA 98284-4322
(360) 854-7400
Mailing address
1020 VAN PL, POWELL, WY 82435-3168
(307) 254-3249
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
RN61281873
WA
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN61281873
WA
Other
Enumeration date
09/01/2023
Last updated
09/01/2023
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