Katreace Katrell Moore, CDP

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CP00006362 Issued in WA

Practice address

325 E Pioneer
Puyallup, WA 98372-3265

Phone

(253) 697-8400

Fax

(253) 697-3730

NPI assigned

Jul 14, 2017

Last updated

Sep 4, 2019By 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 names 1

• Katreace Katrell Sumrell Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1499990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567555200000",
    "number": "1750803383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 LILLY RD NE STE C",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065080",
            "telephone_number": "360-943-8810",
            "fax_number": "360-943-0931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 E PIONEER",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723265",
            "telephone_number": "253-697-8400",
            "fax_number": "253-697-3730"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "908 5th Ave SE",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985011507",
            "country_code": "US",
            "telephone_number": "360-413-6910 x405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KATREACE",
        "middle_name": "KATRELL",
        "credential": "CDP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-14",
        "last_updated": "2019-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP00006362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATREACE",
            "last_name": "SUMRELL",
            "middle_name": "KATRELL",
            "credential": "CDP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Claudia L Montgomery, LMP
• Necashaw Montgomery, LMHCA
• Eric James Moody, LMT
• Won Kyun Moon, M.D.
• Christopher Vincent Moore, MD
• Melinda Moore, ARNP
• Rodney J Moore
• Shannon Lee Moore, ARNP
• Anshul Mor, DMD
• Aleesia Rose Morales

• Addiction (Substance Use Disorder) Counselor in Puyallup, WA
• Providers in Puyallup, 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 Sep 4, 2019; 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.