Individual provider Active NPI

William Joseph Moreau, DC, DACBSP, FACSM

  • Chiropractor
  • Vancouver, WA
National Provider Identifier
1407824071
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH61020299 Issued in WA
Practice address
1499 SE Tech Center PL Ste 350
Vancouver, WA 98683-9575
Phone
(360) 326-2121
Fax
(360) 326-2121
NPI assigned
Mar 9, 2006
Last updated
Apr 22, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 31802 IA
Chiropractor 111N00000X 4822 IA
Chiropractor 111N00000X 3578 MN
Chiropractor 111N00000X CH61020299 WA Primary

Addresses

Primary practice location

1499 SE Tech Center PL Ste 350
Vancouver, WA 98683-9575

Mailing address

1499 SE Tech Center PL Ste 350
Vancouver, WA 98683-9575
Phone (360) 326-2121

Other identifiers 4

IdentifierTypeStateIssuer
350035381OtherIARR MEDICARE
0202531MedicaidIA
3C173MOOtherIAMNBC
57974OtherWELLMARK

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
31802IAMDChiropractor
4822IAMDChiropractor
3578MNMDChiropractor
CH61020299WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Neurosport Concussion and Spine Chiropractor CurrentSince Apr 27, 2025 Accepting new patients
Moreau Chiropractic Clinic Chiropractor Current Accepting new patients

Locations

1820 Central Ave
Estherville, IA 51334
Phone (712) 340-7323

1499 SE Tech Center Pl
Ste 350
Vancouver, WA 98683
Phone (360) 326-2121

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1407824071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1499 SE TECH CENTER PL STE 350",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986839575",
            "telephone_number": "360-326-2121",
            "fax_number": "360-326-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1499 SE TECH CENTER PL STE 350",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986839575",
            "telephone_number": "360-326-2121",
            "fax_number": "360-326-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOREAU",
        "first_name": "WILLIAM",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DC, DACBSP, FACSM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "31802",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "4822",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3578",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH61020299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "350035381",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0202531",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MNBC",
            "identifier": "3C173MO",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "57974",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; 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.