Provider Demographics
NPI:1356679369
Name:MOE, BARBARA ELISE (MA,RN,GMHS,MHP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ELISE
Last Name:MOE
Suffix:
Gender:F
Credentials:MA,RN,GMHS,MHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10407 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98204-3540
Mailing Address - Country:US
Mailing Address - Phone:425-374-5610
Mailing Address - Fax:425-267-9779
Practice Address - Street 1:10407 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204-3540
Practice Address - Country:US
Practice Address - Phone:425-374-5610
Practice Address - Fax:425-267-9779
Is Sole Proprietor?:No
Enumeration Date:2009-12-02
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00013967101YM0800X
WARN00039663163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health