| Doctor Name: | MS. TAMMY H. MOORE |
| NPI Number: | 1063440964 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | AP30006758 |
| Business Practice Address: | 600 E. Main Street Elma, WA - 98541 |
| Business Phone Number: | 3604953244 |
| Business Fax Number: | 3604953364 |
| Mailing Address: | 600 E. Main Street, ELMA |
| State: | WA |
| Postal Code: | 98541 |
| Phone Number: | 3604953244 |
| Fax Number: | 3604953364 |
| NPI Enumeration Date: | 06/29/2006 |
| NPI Last Update Date: | 02/17/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | AP30006758 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |