Healthcare Provider Details

I. General information

NPI: 1982745246
Provider Name (Legal Business Name): THE MOORE CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 114TH AVE SE SUITE 180
BELLEVUE WA
98004-6950
US

IV. Provider business mailing address

PO BOX 1132
MERCER ISLAND WA
98040-1132
US

V. Phone/Fax

Practice location:
  • Phone: 425-451-1134
  • Fax: 425-451-8501
Mailing address:
  • Phone: 425-451-1134
  • Fax: 425-451-8501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MEHRI D MOORE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 425-451-1134