| NPI | 1649979329 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLEEN MARIE-KIESER MOORE AO 509-903-8766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| 363LG0600X Nurse Practitioner, Gerontology | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2023-03-01 |
| Last Update Date | 2026-07-06 |