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General NPI Number Information
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NPI Number | 1336974195
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Entity Type | Organization
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Legal Business Name | MOORE FAMILY CLINICS, PLLC
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Dates
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Enumeration Date | 09/03/2024
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 318 E ROWAN AVE STE 201
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City | SPOKANE
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State | WA
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Zip | 99207-1200
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Country | US
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Telephone | 509-275-8600
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 530
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City | COLBERT
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State | WA
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Zip | 99005-0530
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Country | US
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Telephone | 509-275-8600
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Fax | 509-275-2333
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Authorized Official
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Title or Position | CEO / PROVIDER
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Name | SHANNA MARIE MOORE
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Credential | MSN, APRN, FNP-C
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Telephone | 509-275-8600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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