Provider Demographics
NPI:1841439890
Name:MOORE, NATHAN ARNOLD (DC)
Entity type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:ARNOLD
Last Name:MOORE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4634 E. MARGINAL WAY S.
Mailing Address - Street 2:#C-120
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98134
Mailing Address - Country:US
Mailing Address - Phone:206-932-7943
Mailing Address - Fax:206-932-8686
Practice Address - Street 1:4634 E. MARGINAL WAY S.
Practice Address - Street 2:#C-120
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98134
Practice Address - Country:US
Practice Address - Phone:206-932-7943
Practice Address - Fax:206-932-8686
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-16
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60064500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor