Individual provider Active NPI

Seana M Moore, ARNP

  • Obstetrics & Gynecology Nurse Practitioner
  • Yakima, WA
National Provider Identifier
1497857015
Registry record updated Jul 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
AP30007145 Issued in WA
Practice address
3003 Tieton Dr
Suite 230
Yakima, WA 98902-3684
Phone
(509) 248-3440
Fax
(509) 452-1648
NPI assigned
Sep 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN00142455 WA
Nurse Practitioner 363L00000X P30007145 WA
Obstetrics & Gynecology Nurse Practitioner 363LX0001X AP30007145 WA Primary

Addresses

Primary practice location

3003 Tieton Dr
Suite 230
Yakima, WA 98902-3684

Mailing address

3003 Tieton Dr
Suite 230
Yakima, WA 98902-3684
Phone (509) 248-3440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060127000244 WA Practitioner - Nurse Practitioner 7416961594 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yakima Valley Memorial PhysiciansGroup PAC ID 1557391596, 397 clinicians

Practice addresses (Care Compare)

3003 Tieton Dr
Suite 230
Yakima, WA 98902-3684
Phone (509) 248-3440

Hospital & facility affiliations

  • Yakima Valley Memorial Hospital, Yakima, WA, CCN 500036

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
P30007145WAMDNurse Practitioner
RN00142455WAMDNurse Practitioner
AP30007145WAMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Yakima Valley Memorial Physicians CurrentSince Sep 1, 2020 Accepting new patients
Yakima Valley Memorial Physicians CurrentSince Sep 1, 2020 Accepting new patients

Locations

2811 Tieton Dr
Yakima, WA 98902
Phone (509) 249-5210

3003 Tieton Dr
Ste 230
Yakima, WA 98902
Phone (509) 248-3440

Interoperability endpoints

  • Direct secure messaging: smoore772920@direct.multicare.org

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1157241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1497857015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 TIETON DR",
            "address_2": "SUITE 230",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023684",
            "telephone_number": "509-248-3440",
            "fax_number": "509-452-1648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 TIETON DR",
            "address_2": "SUITE 230",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023684",
            "telephone_number": "509-248-3440",
            "fax_number": "509-452-1648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SEANA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-03",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "RN00142455",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "P30007145",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "WA",
            "license": "AP30007145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.