Individual
MS. MAURA LEE MUZZALL-MOORE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
529 JASMINE ST, OMAK, WA 98841-9589
(529) 826-1600
(509) 826-3633
Mailing address
PO BOX 3188, OMAK, WA 98841-3188
(509) 826-1600
(509) 826-3633
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA10000002975
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0176649
WORKERS COMPENSATION
WA
01
—
5530MU
ASURIS INSURANCE CO,
WA
05
—
8371858
—
WA
01
—
8931006
CRIME VICTIM COMPENSATION
WA
Enumeration date
05/12/2006
Last updated
07/08/2007
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