JENNIFER MOORE (NPI# 1255788295) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255788295 |
| Entity Type | Individual |
| Full Name | JENNIFER MOORE |
| Practice Address |
1802 Yakima Ave Ste 204 Tacoma WA 98405 |
| Mailing Address |
4311 11th Ave Ne Suite 200 Seattle WA 98105-6366 |
| Practice Telephone | 2533828540 |
| Practice Fax Number | 2533828545 |
| Mailing Telephone | 2066164001 |
| Mailing Fax Number | 2066163889 |
| Enumeration Date | 2016-05-19 |
| Last Update Date | 2018-07-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA60803139 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215536370 | Jennifer Lynn Moore | Nurse Practitioner | 203 N College Ave Ste 1001, Cleveland, TX 77327-2500 | 2020-10-20 |
| 1790332104 | Jennifer Dawn Moore | Technician | 3154 Jackson Bridge Rd, Carnesville, GA 30521-4126 | 2019-08-20 |
| 1427522192 | Jennifer G Moore | Speech-Language Pathologist | 2500 Cherry Ln, Northbrook, IL 60062-4414 | 2019-01-16 |
| 1548735632 | Jennifer Moore | Counselor | 11706 W Chenango Dr Apt 3, Morrison, CO 80465-2020 | 2018-10-04 |
| 1295218667 | Jennifer Elaine Moore | Registered Nurse | 185 Vz Cr 2103, Canton, TX 75103 | 2018-09-12 |
| 1942788104 | Jennifer Heine Moore | Licensed Vocational Nurse | 315 S Grand Saline St, Canton, TX 75103-1355 | 2018-07-31 |
| 1134639636 | Jennifer A Moore | Psychologist | 310 S Walnut Bend Rd Ste 2, Cordova, TN 38018-7282 | 2017-10-10 |
| 1346778214 | Jennifer Moore | Counselor | 348 Prior Ave N Ste 205, Saint Paul, MN 55104-5591 | 2017-05-23 |
| 1194263665 | Jennifer Moore | Occupational Therapist | 6540 Havens Corners Rd, Blacklick, OH 43004-8415 | 2017-02-06 |
| 1790237329 | Jennifer Moore | Student in an Organized Health Care Education/Training Program | 281 Winter St Ste 240, Waltham, MA 02451-8713 | 2016-10-31 |
| Street Address |
1802 YAKIMA AVE STE 204 |
| City | TACOMA |
| State | WA |
| Zip Code | 98405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053324186 | Tommy Lamar Jackson | Physician Assistant | 1802 Yakima Ave Ste 204, Tacoma, WA 98405-5304 | 2006-08-13 |
| 1083919682 | Elaine Catherine Kiser-rude | Physician Assistant | 1802 Yakima Ave Ste 204, Tacoma, WA 98405-5304 | 2011-01-13 |
| 1104050814 | Hao Trong Vu | Surgery | 1802 Yakima Ave Ste 204, Tacoma, WA 98405-5304 | 2009-05-08 |
| 1770675837 | Donna S Watson | Nurse Practitioner | 1802 Yakima Ave Ste 204, Tacoma, WA 98405-5304 | 2006-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609486026 | Joanna Christine Hope | Physician Assistant | 2502 S Union Avenue, Tacoma, WA 98405 | 2020-08-01 |
| 1467077891 | Richard Jimenez | Student in an Organized Health Care Education/Training Program | 1202 M.l.k. Jr Way Suite #310, Tacoma, WA 98405 | 2020-06-11 |
| 1669008785 | Mariana Sanchez Corona | Behavior Technician | 1901 S Union Ave Allenmore Building B, Tacoma, WA 98405 | 2020-03-20 |
| 1811534845 | Jasmine Gregory | Social Worker | 311 Martin Luther King Jr. Way, Ms:315-c2-php, Tacoma, WA 98405 | 2019-12-10 |
| 1548807506 | Holly Rebecca Brezynski | Student in an Organized Health Care Education/Training Program | Fresenius Kindney Care - Home Therapies Department, 1717 South J Street, Tacoma, WA 98405 | 2019-12-09 |
| 1972064392 | Logan Brau | Student in an Organized Health Care Education/Training Program | 1202 M.l.k. Jr Way, Tacoma, WA 98405 | 2019-03-28 |
| 1629532536 | Preferred Orthotic and Prosthetic Services Inc | Prosthetic/Orthotic Supplier | 1708 Yakima Ave Ste 60, Tacoma, WA 98405 | 2019-01-24 |
| 1669945911 | Heidi Weakley | Counselor | 1001 S Yakima Ave, Suite 5, Tacoma, WA 98405 | 2019-01-09 |
| 1972074011 | Taviance Benet Laster | Behavior Technician | 1416 S 9th St, Tacoma, WA 98405 | 2018-12-16 |
| 1336618040 | Bailey Bangerter | Physician Assistant | 1901 South Union, A-233, Tacoma, WA 98405 | 2018-11-26 |
| Find all providers in zip 98405 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609486026 | Joanna Christine Hope | Physician Assistant | 2502 S Union Avenue, Tacoma, WA 98405 | 2020-08-01 |
| 1831663442 | Noah C Chance | Physician Assistant | 9040 Jackson Ave Attn:credentials, Tacoma, WA 98431-4604 | 2019-01-16 |
| 1336618040 | Bailey Bangerter | Physician Assistant | 1901 South Union, A-233, Tacoma, WA 98405 | 2018-11-26 |
| 1518448539 | Kimberly Bui | Physician Assistant | 112 S 8th St Ste 200, Tacoma, WA 98402-5294 | 2018-08-27 |
| 1568942621 | Michelle Lynn Scott | Physician Assistant | 1201 Pacific Ave Ste C6, Tacoma, WA 98402-4393 | 2018-08-17 |
| 1548770670 | Bradley Richard Poe | Physician Assistant | 209 M.l.k. Jr Way, Tacoma, WA 98405 | 2017-10-03 |
| 1326588369 | Alyssa K. Leaning | Physician Assistant | 1724 W Union Ave Ste 100, Tacoma, WA 98405-2099 | 2017-02-23 |
| 1356609218 | Rebecca Ann Sciandra | Physician Assistant | 9040a Jackson Ave Madigan Army Medical Center, Tacoma, WA 98431-7037 | 2012-04-30 |
| 1023392529 | Kristie Michelle Mattern | Physician Assistant | 5427 S Birmingham St, Tacoma, WA 98409-5417 | 2011-10-03 |
| 1700100385 | Colleen Anne Carette | Physician Assistant | 1500 N. Warner St., #1035, Tacoma, WA 98416-1035 | 2010-03-25 |
| Find all providers in TACOMA | ||||
Please comment or provide details below to improve the information on JENNIFER MOORE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.