Healthcare Provider Details

I. General information

NPI: 1033325501
Provider Name (Legal Business Name): MARKEE & MOORE PSYCHOLOGISTS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 01/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2009 F STREET
VANCOUVER WA
98663
US

IV. Provider business mailing address

2009 F STREET
VANCOUVER WA
98663
US

V. Phone/Fax

Practice location:
  • Phone: 360-693-3715
  • Fax:
Mailing address:
  • Phone: 360-693-3715
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number2014
License Number StateWA

VIII. Authorized Official

Name: DR. LAWRENCE HAROLD MOORE
Title or Position: VICE-PRESIDENT
Credential: PH.D.
Phone: 360-693-3715