Healthcare Provider Details

I. General information

NPI: 1023948650
Provider Name (Legal Business Name): ROXANNE MOORE PHD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1313 E MAPLE ST STE 210
BELLINGHAM WA
98225-5708
US

IV. Provider business mailing address

1313 E MAPLE ST STE 210
BELLINGHAM WA
98225-5708
US

V. Phone/Fax

Practice location:
  • Phone: 360-393-9939
  • Fax:
Mailing address:
  • Phone: 360-393-9939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. ROXANNE ROSE MOORE
Title or Position: MANAGING MEMBER
Credential: PHD
Phone: 360-393-9939