Moore, Vicki Darlene
Moore, Vicki Darlene is an individual health care provider with primary practice located at 3181 Sw Sam Jackson Park Rd , Portland OR 97239-3011. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Acute Care, which is considered as her primary health care specialty. Moore, Vicki Darlene can be contacted via phone (503) 494-7481.Contact Information
Primary practice address
3181 Sw Sam Jackson Park Rd
Portland OR 97239-3011
Phone: (503) 494-7481
Fax: (503) 494-0822
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Acute Care | 363LA2100X | 201809959NPPP | Oregon |
Profile Details
| NPI number | 1023193745 |
|---|---|
| LBN Legal business name | Moore, Vicki Darlene |
| Credentials | RN, MSN, ACNP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 25th, 2006 |
| Last updated | Jan 13th, 2020 - about 5 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 | 1023193745 | NPPES |
| California | Other | CA122795 | MEDICARE PTAN |
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