Individual
KATHRYN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
1709 STATE AVE NE, OLYMPIA, WA 98506-4556
(360) 570-8151
(360) 943-6602
Mailing address
7910 114TH LN SW, OLYMPIA, WA 98512-8585
(360) 570-9900
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00009757
WA
Other
Enumeration date
02/12/2016
Last updated
02/12/2016
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