| Doctor Name: | DR. RODERICK ALAN MOORE |
| NPI Number: | 1104978238 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPM |
| License Number: | PO00000305 |
| Business Practice Address: | 17000 140th Ave Ne Unit 201 Woodinville, WA - 980726928 |
| Business Phone Number: | 4254817055 |
| Business Fax Number: | |
| Mailing Address: | 17000 140th Ave Ne, Unit 201 WOODINVILLE |
| State: | WA |
| Postal Code: | 980726928 |
| Phone Number: | 4254817055 |
| Fax Number: | |
| NPI Enumeration Date: | 01/17/2007 |
| NPI Last Update Date: | 08/12/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | PO00000305 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |