Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist | ||
Y | 102L00000X | Psychologist | PY61068382 | WA |
Y | 103T00000X | Psychologist | PY61068382 | WA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | ||
N | 103TC2200X | Clinical Child & Adolescent Psychologist | PY61068382 | WA |
N | 103TS0200X | School Psychologist | ||
N | 103TS0200X | School Psychologist | PY61068382 | WA |
NPI | 1003572819 |
---|---|
Provider Name | Dr. Gregory Eugene Moy |
First Address | Seattle, WA 98144-6819 |
Second Address | Seattle, WA 98144-6819 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2021 |
Last Update Date | 16/11/2021 |