Active NPI
Malia Moore
- Speech-Language Pathologist
- Anacortes, WA
National Provider Identifier
1962902460
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 60631049
- Practice address
- 1105 27TH St
Anacortes, WA 98221-2710 - Phone
- (360) 293-3174
- NPI assigned
- Feb 20, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 60631049 | WA | Primary |
Addresses
Primary practice location
1105 27TH St
Anacortes, WA 98221-2710
Mailing address
1037 Mountain Cir
Oak Harbor, WA 98277-4147
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 60631049 | Other | WA | WASHINGTON STATE DEPT OF HEALTH |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60631049 | WA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519084800000",
"number": "1962902460",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1037 MOUNTAIN CIR",
"city": "OAK HARBOR",
"state": "WA",
"postal_code": "982774147"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1105 27TH ST",
"city": "ANACORTES",
"state": "WA",
"postal_code": "982212710",
"telephone_number": "360-293-3174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "MALIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-02-20",
"last_updated": "2018-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WA",
"license": "60631049",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WASHINGTON STATE DEPT OF HEALTH",
"identifier": "60631049",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Anacortes, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.