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DR. LAWRENCE HAROLD MOORE PH.D.

Clinical Neuropsychologist

Vancouver, Washington

Provider NPI: 1215143821

Provider Information:
DR. LAWRENCE HAROLD MOORE PH.D.
Gender: M
Not Sole Proprietor

Practice Location:
2009 F STREET  VANCOUVER, WA 98663 US
Tel: 360-693-3715  Fax: 360-737-8269

Business Mailing Address:
2009 F STREET  VANCOUVER, WA 98663 US
Tel: 360-693-3715  Fax: 360-737-8269

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
OR1515
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
WA2014

Other Provider Identifiers:

IssuerNumberStateType
DEPT OF LABOR & INDUSTRIE169713WA01
7078918WA05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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