Patricia Ann Keith Moore, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP30000304 Issued in WA

Practice address

2103 NE 272ND Ave
Camas, WA 98607-9749

Phone

(360) 852-5783

Fax

(360) 834-4403

NPI assigned

Sep 5, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Patricia Moore Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Physician Assistant

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 and National Provider Directory roles.

• Geriatric Psychiatry Associates Northwest, P.C.

  • Geriatric Psychiatry Physician
  • Portland, OR
  • NPI 1760674071
  NPD (past)

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

{
    "created_epoch": "1220572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458691200000",
    "number": "1902054604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2103 NE 272ND AVE",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986079749",
            "telephone_number": "360-852-5783",
            "fax_number": "360-834-4403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 NE 272ND AVE",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986079749",
            "telephone_number": "360-852-5783",
            "fax_number": "360-834-4403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEITH MOORE",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-05",
        "last_updated": "2016-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP30000304",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201508595NP-PP",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIA",
            "last_name": "MOORE",
            "credential": "ARNP, PA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• CJ Jones, MA 60554080
• Erin K Jones, LMP
• Jeremy Jones, DPT
• Jeannie Kay, HIS
• Patrick R. Keavney, LMP
• Jaspreet Kaur Khangura, M.D.
• Ashley Doyle Khemraj, LAC, LMT
• Kind Care Dentistry
• Landon George King, D.D.S.
• Maria Joanne Kintz, LMP

• Family Nurse Practitioner in Camas, WA
• Providers in Camas, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2016; 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.