| Kenneth E Moore, PA C | |
|
1313 N 13th Ave, Walla Walla, WA 99362-8817 | |
| (509) 200-2852 | |
| (509) 522-5899 |
| Full Name | Kenneth E Moore |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 1313 N 13th Ave, Walla Walla, Washington |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013023407 | NPI | - | NPPES |
| 1081678 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA10003031 (Washington) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth E Moore, PA C 615 University St, Walla Walla, WA 99362-2338 Ph: (509) 200-2852 | Kenneth E Moore, PA C 1313 N 13th Ave, Walla Walla, WA 99362-8817 Ph: (509) 200-2852 |
Abigail Bradley, Physician Assistant Medicare: Medicare Enrolled Practice Location: 380 Chase Ave, Walla Walla, WA 99362 Phone: 509-897-5950 Fax: 509-879-5570 | |
Stacey Renee Haveman, PHYSICIAN ASSISTANT Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 55 W Tietan St, Walla Walla, WA 99362 Phone: 509-525-3720 Fax: 509-522-1592 | |
Douglas Edison West, PAC Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 301 W Poplar St, Ste 220, Walla Walla, WA 99362 Phone: 509-522-1030 Fax: 509-529-6066 | |
Alexis Ivy Weinrich, Physician Assistant Medicare: Medicare Enrolled Practice Location: 55 W Tietan St, Walla Walla, WA 99362 Phone: 509-525-3720 Fax: 509-522-1581 | |
Erin Nova Fletcher, PA STUDENT Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1120 W Rose St, Walla Walla, WA 99362 Phone: 509-525-6650 Fax: 509-522-2349 | |
Joshua Wicks, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 380 Chase Ave, Walla Walla, WA 99362 Phone: 509-522-5820 |