| 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 |
|---|---|
| Provider Enumeration Date | 05/14/2007 |
| Last Update Date | 01/21/2015 |
| Medicare PECOS PAC ID | 2365332384 |
|---|---|
| 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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