Moore, Thomas
Moore, Thomas is an sole proprietor health care provider with primary practice located at 66 Club Rd Ste 140 , Eugene OR 97401-2491. He recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Nursing Service Providers / Psychiatric/Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is his primary health care specialty. Moore, Thomas can be contacted via phone (541) 345-1722.Contact Information
Primary practice address
66 Club Rd Ste 140
Eugene OR 97401-2491
Phone: (541) 345-1722
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Providers / Registered Nurse | 163W00000X | RN61231272 | Washington |
| Nursing Service Providers / Registered Nurse | 163W00000X | 202002591RN | Oregon |
| Nursing Service Providers / Psychiatric/Mental Health | 163WP0808X | 041393235 | Illinois |
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | AP61231376 | Washington |
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | 209017885 | Illinois |
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | 202002776NP-PP | Oregon |
Profile Details
| NPI number | 1538598487 |
|---|---|
| LBN Legal business name | Moore, Thomas |
| Credentials | PMHNP-BC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 1st, 2013 |
| Last updated | Mar 1st, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1538598487 | NPPES |
| Oregon | MEDICAID | 500778964 | |
| Oregon | MEDICAID | 500801827 |
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