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General NPI Number Information
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NPI Number | 1083139281
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Entity Type | Individual
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Provider Name | KAYLA MOORE MS, LMFT
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Gender | Female
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Dates
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Enumeration Date | 08/08/2017
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Last Update Date | 11/26/2019
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Provider Practice Location Address
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Address Line | 4141 6TH AVE STE C
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City | TACOMA
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State | WA
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Zip | 98406-4034
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Country | US
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Telephone | 253-525-2424
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Fax |
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Provider Business Mailing Address
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Address Line | 1330 211TH PL SW
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City | LYNNWOOD
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State | WA
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Zip | 98036-8676
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Country | US
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Telephone | 206-948-5189
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFTA.MG.60778639
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LF60995323
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License Number State | WA
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