Kenneth E Moore, PA C
NPI #1013023407 in Walla Walla, Washington
Provider Information
- NPI Number
- 1013023407
- Entity Type
- Individual
- Name
- Kenneth E Moore, PA C
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant
- Credential
- PA C
- Enumeration Date
- Aug 21, 2006
- Last Updated
- Jun 30, 2009
Practice Location
- Address
- 1313 N 13TH AVE
- City
- Walla Walla
- State
- Washington
- ZIP Code
- 99362-8817
- Phone
- (509) 200-2852
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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