Justin Thomas Moore, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP61668130 Issued in WA

Practice address

503 E 26TH St
Tacoma, WA 98421-1343

Phone

(253) 881-7001

NPI assigned

Mar 29, 2025

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Justin Thomas Moore Professional name

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Puyallup Tribal Opioid Clinic, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Tacoma, WA
  • NPI 1992582613

  TX

  Medicare reassignment
• Revive Pathway

  • Substance Use Disorder Rehabilitation Clinic/Center
  • El Cajon, CA
  • NPI 1962117440

  TX

  Medicare reassignment
• New Life Health Authority

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Ukiah, CA
  • NPI 1104435734
  NPD

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

{
    "created_epoch": "1743206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743206400000",
    "number": "1275336893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 E 26TH ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984211343",
            "telephone_number": "253-881-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 E 26TH ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984211343",
            "telephone_number": "253-881-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JUSTIN",
        "middle_name": "THOMAS",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-03-29",
        "last_updated": "2025-03-29",
        "certification_date": "2025-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61668130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUSTIN",
            "last_name": "MOORE",
            "middle_name": "THOMAS",
            "prefix": "MR.",
            "credential": "PMHNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Douglas Bernard Moore, PA-C
• George Stanley Moore, RPH
• Jane Ann Moore, MD
• Jonathan Tad Moore, PHD
• Julie Ann Moore, OTR/L
• Kari Lynn Moore
• Kathryn Anne Moore, LMP
• Kayla Moore, MS, LMFT
• Kimberly Lynn Moore, MD
• Maloy Moore

• Psychiatric/Mental Health Nurse Practitioner in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.