Individual
JANELLE RAE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
PO BOX 340, ODESSA, WA 99159-0340
(509) 988-0076
Mailing address
PO BOX 340, ODESSA, WA 99159-0340
(509) 988-0076
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2084P0800X
WA
Other
Enumeration date
07/22/2024
Last updated
07/22/2024
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