JACQUELINE MOORE PLLC NPI 1093602906

NPI Information

  • NPI: 1093602906
  • Provider Name: JACQUELINE MOORE PLLC
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Organization
  • Address: 701 NE 136TH AVE STE 200
    VANCOUVER, WA
    ZIP 98684
  • Phone: (360) 322-4711

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NPI Details

JACQUELINE MOORE PLLC is a psychiatric/mental health nurse practitioner in Vancouver, WA. JACQUELINE MOORE PLLC NPI is 1093602906. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

701 NE 136TH AVE STE 200
VANCOUVER, WA
ZIP 98684-937
Phone: (360) 322-4711
Fax: (360) 583-6404

The provider's authorized official is Jacqueline Marie Moore .
The authorized official title is Owner/provider and has the following contact phone number (360) 322-4711.

The enumeration date for this NPI number is 6/23/2025 and was last updated on 6/23/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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