Individual
YASMINE MARSHAE' MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CMA
Contact information
Practice address
847 NE 19TH AVE STE 100, PORTLAND, OR 97232-2684
(503) 238-0769
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
(503) 238-0769
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
937020
NCCT CERTIFIED MEDICAL ASSISTANT
OR
01
—
CM60712834
WASHINGTON STATE DEPARTMENT OF HEALTH
WA
Enumeration date
05/08/2019
Last updated
05/08/2019
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