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General NPI Number Information
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NPI Number | 1104948249
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Entity Type | Individual
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Provider Name | DAVID RICHARD MOORE M.S, BC-HIS
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Gender | Male
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 17309 139TH AVE NE
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City | WOODINVILLE
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State | WA
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Zip | 98072-8571
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Country | US
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Telephone | 425-487-3942
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Fax | 425-489-3092
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Provider Business Mailing Address
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Address Line | 17309 139TH AVE NE
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City | WOODINVILLE
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State | WA
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Zip | 98072-8571
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Country | US
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Telephone | 425-487-3942
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Fax | 425-489-3092
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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 | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | HA00003843
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License Number State | WA
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