Provider Demographics
NPI:1922746411
Name:MOREN, JOHN PAUL (RN)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:PAUL
Last Name:MOREN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
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Mailing Address - Street 1:1040 S HENDERSON ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98108-4720
Mailing Address - Country:US
Mailing Address - Phone:206-763-5277
Mailing Address - Fax:360-397-8494
Practice Address - Street 1:1601 E FOURTH PLAIN BLVD
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-3713
Practice Address - Country:US
Practice Address - Phone:360-909-5133
Practice Address - Fax:360-397-8494
Is Sole Proprietor?:No
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WARN60289405163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult