Individual
JENNA MARIE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2505 SULWHANON DR., EVERSON, WA 98247-9602
(360) 966-2376
(360) 966-3413
Mailing address
PO BOX 7723, HILO, HI 96720-8949
(330) 881-4475
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LH60940611
WA
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
02/17/2014
Last updated
03/04/2026
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