Wendy Michel Moore, MA PHYSICAL THERAPY

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2036 Issued in OR

Practice address

2701 NW Vaughn St
Montgomery Park Office
Portland, OR 97210-5311

Phone

(503) 499-5200

NPI assigned

Aug 18, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235243296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14257 EDENBERRY DR",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970356700",
            "telephone_number": "503-639-6014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 NW VAUGHN ST",
            "address_2": "MONTGOMERY PARK OFFICE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972105311",
            "telephone_number": "503-499-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "WENDY",
        "middle_name": "MICHEL",
        "name_prefix": "Mr.",
        "credential": "MA PHYSICAL THERAPY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "2036",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00006261",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tieara Elizabeth Moore
• Tracy Moore, RD
• Tyna Lee Moore, N.D., D.C.
• Vicki Darlene Moore, RN, MSN, ACNP
• Vincent Andrew Moore, MD, MPH&TM
• William Moore, D.M.D.
• William Moore III, DC
• Yasmine Marshae' Moore, CMA
• Anne Elizabeth Moorehead
• John Couper Moorhead, MD

• Physical Therapist in Portland, OR
• Providers in Portland, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.