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General NPI Number Information
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NPI Number | 1013328400
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Entity Type | Organization
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Legal Business Name | THE MOORE CENTER, PC
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Dates
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Enumeration Date | 05/19/2014
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Last Update Date | 04/29/2024
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Provider Practice Location Address
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Address Line | 1231 116TH AVE NE 8TH FLOOR
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City | BELLEVUE
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State | WA
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Zip | 98004-3804
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Country | US
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Telephone | 425-454-1010
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Fax | 425-451-8501
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Provider Business Mailing Address
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Address Line | 1231 116TH AVE NE 8TH FLOOR
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City | BELLEVUE
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State | WA
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Zip | 98004-6950
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Country | US
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Telephone | 425-454-1010
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Fax | 425-451-8501
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Authorized Official
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Title or Position | CONTRACTING & CREDENTIALING MANAGER
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Name | MARINA SHEPEL
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Credential |
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Telephone | 206-383-4781
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number | RTF.FS.60450314
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License Number State | WA
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