Active NPI
Tessa Elizabeth Moore, MD
- Family Medicine Physician
- Chewelah, WA
National Provider Identifier
1003565177
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD61583267
- Practice address
- 100 W South Ave
Chewelah, WA 99109-9684 - Phone
- (509) 935-8111
- Fax
- (509) 935-0970
- NPI assigned
- Mar 23, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD61583267 | WA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
100 W South Ave
Chewelah, WA 99109-9684
Mailing address
PO Box 31001-4114
Pasadena, CA 91110-4114
Phone (866) 747-2455
Other practice location 1
331 NE Thornton Pl
Seattle, WA 98125-8021
Phone (206) 528-8000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Washington School of Medicine, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Colville Medical Center PSProvidence Health and Services - Washington
Practice addresses (Care Compare)
100 W S Ave
Chewelah, WA 99109-9684
Phone (509) 935-8111
1200 E Columbia Ave
Colville, WA 99114-3354
982 E Columbia Ave
Colville, WA 99114-3316
Phone (509) 684-2561
Hospital & facility affiliations
- Assured Home Health
- Providence St Joseph Hospital
- Providence Mount Carmel Hospital
- Providence Mount Carmel Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD61583267 | WA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Health & Services Washington | Family Medicine | Current | Accepting new patients |
| Providence Health & Services - Washington | Past | Accepting new patients |
Locations
100 W South Ave
Chewelah, WA 99109
Phone (509) 684-3701
1200 E Columbia Ave
Colville, WA 99114
Phone (509) 684-3701
Interoperability endpoints
- https://fhir-usa.unify.chbase.com/org/chelan-e607b8fe
- tmoore1016940@wm.providencedirect.org
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pulmonary Disease Physician
- Spokane, WA
- NPI 1194099390
Family Medicine, WA
-
- Substance Use Disorder Rehabilitation Hospital Unit
- Hoquiam, WA
- NPI 1043374119
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Spokane Valley, WA
- NPI 1336379015
-
- Critical Access Hospital
- Colville, WA
- NPI 1003067679
Hospital
-
- Medicare Defined Swing Bed Hospital Unit
- Colville, WA
- NPI 1134371628
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754524800000",
"number": "1003565177",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 31001-4114",
"city": "PASADENA",
"state": "CA",
"postal_code": "911104114",
"telephone_number": "866-747-2455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 W SOUTH AVE",
"city": "CHEWELAH",
"state": "WA",
"postal_code": "991099684",
"telephone_number": "509-935-8111",
"fax_number": "509-935-0970"
}
],
"practiceLocations": [
{
"address_1": "331 NE Thornton Pl",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "981258021",
"country_code": "US",
"telephone_number": "206-528-8000",
"fax_number": "206-520-2399",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOORE",
"first_name": "TESSA",
"middle_name": "ELIZABETH",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-23",
"last_updated": "2025-08-07",
"certification_date": "2025-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "MD61583267",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chewelah, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.