Active NPI
Stephen Daniel Moore, R.PH.
- Pharmacist
- Airway Heights, WA
National Provider Identifier
1184614513
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH00010237
- Practice address
- 11919 W Sprague Ave
Airway Heights, WA 99001-1899 - Phone
- (509) 244-6838
- Fax
- (509) 244-6795
- NPI assigned
- Oct 26, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH00010237 | WA | Primary |
Addresses
Primary practice location
11919 W Sprague Ave
Airway Heights, WA 99001-1899
Mailing address
5366 S Squaw Bay Rd
Harrison, ID 83833-9440
Phone (208) 676-0707
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH00010237 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1184614513",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5366 S SQUAW BAY RD",
"city": "HARRISON",
"state": "ID",
"postal_code": "838339440",
"telephone_number": "208-676-0707",
"fax_number": "509-244-6795"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11919 W SPRAGUE AVE",
"city": "AIRWAY HEIGHTS",
"state": "WA",
"postal_code": "990011899",
"telephone_number": "509-244-6838",
"fax_number": "509-244-6795"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "STEPHEN",
"middle_name": "DANIEL",
"credential": "R.PH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-26",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH00010237",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Airway Heights, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.