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General NPI Number Information
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NPI Number | 1710189360
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Entity Type | Individual
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Provider Name | PAMELA ANN MOORE PMHNP
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Gender | Female
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Dates
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Enumeration Date | 06/05/2007
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Last Update Date | 01/28/2014
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Provider Practice Location Address
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Address Line | 9600 SW OAK ST SUITE 525
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City | TIGARD
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State | OR
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Zip | 97223-6583
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Country | US
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Telephone | 503-960-3334
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Fax | 503-935-5884
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Provider Business Mailing Address
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Address Line | 9600 SW OAK ST SUITE 525
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City | TIGARD
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State | OR
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Zip | 97223-6583
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Country | US
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Telephone | 503-960-3334
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Fax | 503-935-5884
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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 | 163WP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Registered Nurse
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License Number | 200740981RN
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 200950074NP
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License Number State | OR
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