JACQUELINE FAITH MOORE (NPI# 1679945000) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679945000 |
| Entity Type | Individual |
| Full Name | JACQUELINE FAITH MOORE |
| Other Name | JACQUELINE FITCH |
| Credential | PA-C |
| Practice Address |
5234 Sw Philomath Blvd Corvallis OR 97333-1042 |
| Practice Telephone | 5417684970 |
| Practice Fax Number | 5417684971 |
| Mailing Telephone | 5417684970 |
| Mailing Fax Number | 5417684971 |
| Enumeration Date | 2015-10-26 |
| Last Update Date | 2019-03-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA175138 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689222754 | Jacqueline Blair Moore | Counselor | 14651 Dallas Pkwy Ste 134, Dallas, TX 75254-8904 | 2019-08-30 |
| 1376103838 | Jacqueline Faith Moore | Marriage & Family Therapist | 5450 Ralston St Ste 101, Ventura, CA 93003-6042 | 2019-06-17 |
| 1033611256 | Jacqueline Moore | Registered Nurse | 314 Main St Ste D, Monticello, MS 39654-3702 | 2018-03-03 |
| 1952655466 | Jacqueline Adele Moore | Massage Therapist | 1048 Spinnaker St, Elgin, IL 60123-8587 | 2012-11-06 |
| 1659649002 | Jacqueline Historian Moore | Licensed Practical Nurse | 6256 Hillandale Dr Apt 803, Lithonia, GA 30058-2432 | 2011-12-13 |
| 1619173838 | Jacqueline Diana Moore | Surgery | 2280 Opitz Blvd Ste 110, Woodbridge, VA 22191-3362 | 2007-06-25 |
| 1962059980 | Jacqueline Moore | Speech-Language Pathologist | 5980 Radio Station Rd, La Plata, MD 20646-3337 | 2019-08-23 |
| 1336702638 | Jacqueline Dyan Moore | Student in an Organized Health Care Education/Training Program | 800 Garfield Ave Rm G102, Parkersburg, WV 26101-5340 | 2019-04-22 |
| 1336702315 | Jacqueline Moore | Developmental Therapist | 6239 S East St Ste A, Indianapolis, IN 46227-2088 | 2019-04-16 |
| 1598235889 | Jacqueline Marie Moore | Nurse Practitioner | 101 E 8th St Ste 110, Vancouver, WA 98660-3294 | 2018-11-29 |
| Street Address |
5234 SW PHILOMATH BLVD |
| City | CORVALLIS |
| State | OR |
| Zip Code | 97333-1042 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073593422 | Janet Chang | Family Medicine | 5234 Sw Philomath Blvd, Corvallis, OR 97333-1042 | 2006-01-20 |
| 1427505015 | Michael Duncan | Physician Assistant | 5234 Sw Philomath Blvd, Corvallis, OR 97333-1042 | 2016-09-01 |
| 1649618463 | Maximilian Schilling Kaiser | Family Medicine | 5234 Sw Philomath Blvd, Corvallis, OR 97333-1042 | 2013-06-13 |
| 1780947044 | Joshua Jacob Lenhof | Family Medicine | 5234 Sw Philomath Blvd, Corvallis, OR 97333-1042 | 2012-06-21 |
| 1376809475 | Good Samaritan Hospital Corvallis | Family Medicine | 5234 Sw Philomath Blvd, Corvallis, OR 97333-1042 | 2012-04-03 |
| 1427379650 | Robin William Page-echols | Family Medicine | 5234 Sw Philomath Blvd, Corvallis, OR 97333-1042 | 2010-06-22 |
| 1700015823 | Eric W. Sharp | Family Medicine | 5234 Sw Philomath Blvd, Corvallis, OR 97333-1042 | 2009-07-10 |
| 1316024623 | Courtney A Strand | Nurse Practitioner | 5234 Sw Philomath Blvd, Corvallis, OR 97333 | 2006-11-01 |
| 1205872298 | Nancy J. Vanasche | Registered Nurse | 5234 Sw Philomath Blvd, Corvallis, OR 97333-1042 | 2006-06-20 |
| 1669416673 | Kevin Dj Ewanchyna | Family Medicine | 5234 Sw Philomath Blvd, Corvallis, OR 97333-1042 | 2006-06-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437629037 | Collin Korthauer | Case Manager/Care Coordinator | 1650 Sw 45th Place, Corvallis, OR 97333 | 2018-11-27 |
| 1477079937 | Adam Johnson | Counselor | 518 Sw 3rd, Corvallis, OR 97333 | 2017-08-16 |
| 1386961522 | Michael S. Hanson | Counselor | 518 Sw 3rd St., Corvallis, OR 97333 | 2010-04-28 |
| 1134392376 | Corvallis Physical Therapy Inc | Physical Therapist | 230 Sw 3rd Street Suite 208, Corvallis, OR 97333 | 2008-04-09 |
| 1154529600 | Linda S Lavallee Conniff | Social Worker | 216 Sw Madison Av, #9 10, Corvallis, OR 97333 | 2007-07-06 |
| 1235337056 | Robert R Conniff | Social Worker | 216 Sw Madison Ave, 2, Corvallis, OR 97333 | 2007-07-03 |
| 1619178829 | Trillium Family Services | Residential Treatment Facility, Emotionally Disturbed Children | 4455 Highway North West Highway 20, Corvallis, OR 97333 | 2007-05-29 |
| 1437368867 | Margaret Anne Cooper | Physical Therapist | 230 Sw 3rd Street, Suite 208, Corvallis, OR 97333 | 2007-05-22 |
| 1801009311 | Madeline Elizabeth Rubin | Social Worker | 216 Sw Madison Avenue, Suite 14, Corvallis, OR 97333 | 2007-05-08 |
| 1780707174 | Wheeler John Dale | Internal Medicine | 5060 Sw Philomath Blvd, # 512, Corvallis, OR 97333 | 2007-04-09 |
| Find all providers in zip 97333 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891065348 | Kindra T. Newhart | Physician Assistant | 996 Nw Circle Blvd Ste 103, Corvallis, OR 97330-1485 | 2011-12-30 |
| 1538241120 | Charlotte P Gardner | Physician Assistant | 5234 Sw Philomath Boulevard, Corvallis, OR 97333-1042 | 2006-10-20 |
| 1871682997 | Helen Kathleen Tennican | Physician Assistant | Oregon State University, 201 Plageman Building, Corvallis, OR 97331 | 2006-10-12 |
| 1215022512 | Charla Staggs | Physician Assistant | 2358 Nw Kings Blvd, Suite 100, Corvallis, OR 97330 | 2006-10-03 |
| 1962514836 | Nicole Dianne Wydra | Physician Assistant | 1740 Nw 9th St, Corvallis, OR 97330-2141 | 2006-08-31 |
| 1699798785 | Signe Harrang Wright | Physician Assistant | 5232 Sw Philomath Blvd, Corvallis, OR 97333-1042 | 2006-07-26 |
| 1154373868 | Dena M. Hulting | Physician Assistant | 3521 Nw Samaritan Dr, Suite 101, Corvallis, OR 97330-4744 | 2006-05-17 |
| 1376524694 | Daniel E Stenger | Physician Assistant | 3620 Nw Samaritan Dr, Suite 202, Corvallis, OR 97330-4714 | 2005-11-14 |
| 1487642799 | Dean D Jordan | Physician Assistant | 1122 Ne 2nd St, Corvallis, OR 97330-6227 | 2005-10-11 |
| 1285622589 | Stephen A Bennett | Physician Assistant | 1128 Ne 2nd St, Suite 201, Corvallis, OR 97330-6230 | 2005-10-11 |
| Find all providers in CORVALLIS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.