Vicki Darlene Moore
Nurse Practitioner - Acute Care
3181 Sw Sam Jackson Park Rd
Portland
, Oregon 97239-3011
Vicki Darlene Moore
Nurse Practitioner - Acute Care
3181 Sw Sam Jackson Park Rd
Portland
, Oregon 97239-3011
(503) 494-0822
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About
Features
Specialties
- Nurse Practitioner - Acute Care
Languages spoken
- English
Location
First Address
- Vicki Darlene Moore
- 3181 Sw Sam Jackson Park Rd
- Portland, OR
- Zip : 97239-3011
- Fax : (503) 494-0822
- Phone : (503) 494-7481
Second Address
- Vicki Darlene Moore
- 3181 Sw Sam Jackson Park Rd
- Portland, OR
- Zip : 97239-3011
- Fax : (503) 494-0822
- Phone : (503) 494-7481
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LA2100X | Nurse Practitioner - Acute Care | 201809959NPPP | OR |
National Provider Identifier
| NPI | 1023193745 |
|---|---|
| Provider Name | Vicki Darlene Moore |
| First Address | Portland, OR 97239-3011 |
| Second Address | Portland, OR 97239-3011 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/10/2006 |
| Last Update Date | 13/01/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| CA122795 | MEDICARE PTAN (01) | CA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.