Lawrence H. Moore | |
2009 F Street Vancouver WA 98663 | |
(360) 693-3715 | |
Not Available |
Full Name | Lawrence H. Moore |
---|---|
Speciality | Clinical Neuropsychologist |
Location | 2009 F Street, Vancouver, Washington |
Authorized Official Name and Position | Lawrence Harold Moore (VICE-PRESIDENT) |
Authorized Official Contact | 3606933715 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Lawrence H. Moore 2009 F Street Vancouver WA 98663 Ph: (360) 693-3715 | Lawrence H. Moore 2009 F Street Vancouver WA 98663 Ph: (360) 693-3715 |
NPI Number | 1033325501 |
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Provider Enumeration Date | 05/14/2007 |
Last Update Date | 01/21/2015 |
Medicare PECOS PAC ID | 2365332384 |
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Medicare Enrollment ID | O20040316000127 |
Identifier | Type | State | Issuer |
---|---|---|---|
1033325501 | NPI | - | NPPES |
7078918 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103G00000X | Clinical Neuropsychologist | 2014 (Washington) | Primary |
Provider Name | Lawrence H Moore |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1215143821 PECOS PAC ID: 7517857535 Enrollment ID: I20040330000797 |
Provider Name | Taryn E Markee |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1548312630 PECOS PAC ID: 2062302086 Enrollment ID: I20040330001036 |
Provider Name | Ryan Mangum |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1790311157 PECOS PAC ID: 8123441805 Enrollment ID: I20200714001626 |
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