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General NPI Number Information
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NPI Number | 1871082164
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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 | 05/02/2018
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Last Update Date | 04/29/2024
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Provider Practice Location Address
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Address Line | 901 BOREN AVE SUITE #1800
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City | SEATTLE
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State | WA
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Zip | 98104
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Country | US
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Telephone | 206-971-2266
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Fax | 425-880-5817
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Provider Business Mailing Address
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Address Line | PO BOX 561483
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City | DENVER
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State | CO
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Zip | 80256-1483
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Country | US
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Telephone | 877-825-8589
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Fax | 720-859-3474
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Authorized Official
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Title or Position | DIRECTOR OF INSURANCE CONTRACTING
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Name | CAROL THOMAS
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Credential |
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Telephone | 303-731-8846
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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 | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 200531
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License Number State | WA
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