Courtney Lynn Moore, SUDPT
Counselor, Professional in Port Angeles, WA. Individual provider (NPI-1).
NPI number1336718360
StatusActive
Last updated in NPPESJun 23, 2021
Details
- NPI
- 1336718360
- Entity type
- Individual (NPI-1)
- Name
- Courtney Lynn Moore
- Credential
- SUDPT
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 23, 2021
- Certification date
- Jun 23, 2021
- Last updated
- Jun 23, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | CO61189828 | WA | Yes |
Other names
- Courtney Lynn Counterman (Former Name)
Practice location
3430 E Highway 101 Ste 3Port Angeles, WA 98362-9069
Phone 360-452-4062 · Fax 360-452-4189
Mailing address
Po Box 478Port Angeles, WA 98362-0072
Phone 360-452-4062 · Fax 360-452-4189
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