Basic Information
| Provider Information | |||||||||
| NPI: | 1497857015 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MOORE | ||||||||
| FirstName: | SEANA | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3003 TIETON DR | ||||||||
| Address2: | SUITE 230 | ||||||||
| City: | YAKIMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 989023684 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5092483440 | ||||||||
| FaxNumber: | 5094521648 | ||||||||
| Practice Location | |||||||||
| Address1: | 3003 TIETON DR | ||||||||
| Address2: | SUITE 230 | ||||||||
| City: | YAKIMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 989023684 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5092483440 | ||||||||
| FaxNumber: | 5094521648 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/03/2006 | ||||||||
| LastUpdateDate: | 07/01/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/01/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | RN00142455 | WA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363L00000X | P30007145 | WA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LX0001X | AP30007145 | WA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Obstetrics & Gynecology |
No ID Information.