Lisa Leah Moore, CDP

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CP00000778 Issued in WA

Practice address

2280 Sr 821
Selah, WA 98901

Phone

(509) 457-0990

Fax

(509) 454-4548

NPI assigned

Nov 1, 2018

Last updated

Nov 1, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sundown M Ranch

  • Substance Abuse Rehabilitation Facility
  • Yakima, WA
  • NPI 1154474104
  NPD (past)
• Sundown M Ranch

  • Family Medicine Physician
  • Yakima, WA
  • NPI 1285223305
  NPD (past)

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

{
    "created_epoch": "1541030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541030400000",
    "number": "1265909865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2280 SR 821",
            "city": "SELAH",
            "state": "WA",
            "postal_code": "98901",
            "telephone_number": "509-457-0990",
            "fax_number": "509-454-4548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2280 SR 821",
            "city": "SELAH",
            "state": "WA",
            "postal_code": "98901",
            "telephone_number": "509-457-0990",
            "fax_number": "509-454-4548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "LISA",
        "middle_name": "LEAH",
        "name_prefix": "Mrs.",
        "credential": "CDP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-01",
        "last_updated": "2018-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP00000778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDP",
            "identifier": "CP00000778",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Laurel Miller, PA-C
• Megan Miller
• Jarron Mitchell
• Shirley Mohren-Graves, ARNP
• Saley Karim Molina
• Erin L Morris, PT
• Mower Vision Source, PLLC (Selah Vision Clinic)
• Brett Mower, OD
• Carrie Murphey, LMP
• Shawn Murray, CRNA

• Addiction (Substance Use Disorder) Counselor in Selah, WA
• Providers in Selah, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2018; 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.