Provider Demographics
NPI:1568293009
Name:MOYER, TRICIA
Entity type:Individual
Prefix:
First Name:TRICIA
Middle Name:
Last Name:MOYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TRICIA
Other - Middle Name:
Other - Last Name:GORMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18311 BOTHELL EVERETT HWY STE 180&260
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98012-5233
Mailing Address - Country:US
Mailing Address - Phone:901-420-6250
Mailing Address - Fax:
Practice Address - Street 1:18311 BOTHELL EVERETT HWY STE 180&260
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98012-5233
Practice Address - Country:US
Practice Address - Phone:901-420-6250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst