Individual
PAULA RENEE MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1550 S PIONEER WAY STE 100, MOSES LAKE, WA 98837
(509) 793-9790
(509) 764-3255
Mailing address
660 S COOLIDGE ST, MOSES LAKE, WA 98837-1872
(509) 793-9715
(509) 764-3244
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10130700-1206
UT
363A00000X
Physician Assistant
2019015462
MO
363A00000X
Physician Assistant
5886
AZ
363A00000X
Physician Assistant
Primary
PA.PA.60342285
WA
363A00000X
Physician Assistant
Primary
PA60342285
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2130702
—
WA
Enumeration date
05/05/2006
Last updated
07/31/2026
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