Provider Demographics
NPI:1114062858
Name:MOOR, CHRISTIANA MARIE (MS CCC SLP)
Entity Type:Individual
Prefix:
First Name:CHRISTIANA
Middle Name:MARIE
Last Name:MOOR
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9750 NE 120TH PLACE
Mailing Address - Street 2:SUITE #6
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034
Mailing Address - Country:US
Mailing Address - Phone:425-823-7525
Mailing Address - Fax:
Practice Address - Street 1:9750 NE 120TH PLACE
Practice Address - Street 2:SUITE #6
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034
Practice Address - Country:US
Practice Address - Phone:425-823-7525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00004063235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist