1871082164 NPI number — THE MOORE CENTER PC

Table of content: (NPI 1871082164)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871082164 NPI number — THE MOORE CENTER PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE MOORE CENTER PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
EATING RECOVERY CENTER OF WASHING DBA INSIGHT BEHAVIORAL HEALTH
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1871082164
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/29/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 561483
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DENVER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80256-1483
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
877-825-8589
Provider Business Mailing Address Fax Number:
720-859-3474

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
901 BOREN AVE
Provider Second Line Business Practice Location Address:
SUITE #1800
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-971-2266
Provider Business Practice Location Address Fax Number:
425-880-5817
Provider Enumeration Date:
05/02/2018

Additional Information

Authorized Official

Authorized Official Last Name:
THOMAS
Authorized Official First Name:
CAROL
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF INSURANCE CONTRACTING
Authorized Official Telephone Number:
303-731-8846

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM0850X , with the licence number: 200531 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QM0850X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM0855X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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