KENNETH E MOORE PA C
NPI 1013023407
Physician Assistant in Walla Walla, WA

Active since August 21, 2006
1313 N 13TH AVE, WALLA WALLA, WA 99362(509) 200-2852(509) 522-5899 Get Directions Write a Review

NPPES record last updated: June 30, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Kenneth E Moore Pa C NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENNETH E MOORE PA C (NPI 1013023407) is an individual physician assistant in Walla Walla, Washington, licensed in Washington (PA10003031) and active in the NPI registry since August 2006.

NPPES Registry Identity

NPI1013023407
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameKENNETH E MOORECredential: PA C
Location Address1313 N 13TH AVEWalla Walla, WA 99362-8817
Mailing Address615 University StWalla Walla, WA 99362-2338 · (509) 200-2852
Fax(509) 522-5899
Sole ProprietorNo
Enumeration DateAugust 21, 2006
Last NPPES UpdateJune 30, 2009
NPI 1013023407 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in WA · PA10003031
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
1313 N 13TH AVE, Walla Walla, WA 99362

Other Identifiers 3

Medicare UPINR31829
Medicaid1081678WA
Medicare ID-Type UnspecifiedAB02410WA

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Addiction (Substance Use Disorder))
1313 N 13TH AVE
WALLA WALLA, WA 99362
Registered Nurse (Infection Control)
1313 N 13TH AVE
WALLA WALLA, WA 99362
Counselor (Addiction (Substance Use Disorder))
1313 N 13TH AVE
WALLA WALLA, WA 99362
Physical Therapist
1313 N 13TH AVE
WALLA WALLA, WA 99362
Internal Medicine (Infectious Disease)
1313 N 13TH AVE
WALLA WALLA, WA 99362
Clinic/Center (Physical Therapy)
1313 N 13TH AVE
WALLA WALLA, WA 99362
Pharmacist
1313 N 13TH AVE
WALLA WALLA, WA 99362
Psychiatry & Neurology (Psychiatry)
1313 N 13TH AVE
WALLA WALLA, WA 99362

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kenneth Moore's NPI number?

The NPI number for Kenneth Moore is 1013023407. It was assigned to this individual provider in the NPPES registry on August 21, 2006.

Where is Kenneth Moore located?

Kenneth Moore practices at 1313 N 13th Ave, Walla Walla, WA 99362. The listed phone number is (509) 200-2852.

What is Kenneth Moore's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Kenneth Moore was last updated on June 30, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.