Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Douglas Bernard Moore, PA-C

Individual provider Medical Physician Assistant · NPI 1790853422

Douglas Bernard Moore, PA-C is a Physician Assistant in Tacoma, Washington. Qualified in 2006, 20 years ago. Practices with Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance, a 115-clinician group and accepts Medicare assignment. Licensed in Washington.

Years since qualifying
20
Licensed in
WA
In the registry since
2006
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1304 Fawcett Ave Ste 100
Tacoma, WA 98402-1911
Phone: (253) 761-4200
Fax: (253) 383-3553
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA10005095 (WA)
Medical Physician Assistant Taxonomy 363AM0700X · Licence PA10005095 (WA)

Record details

NPI number1790853422
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedDecember 1, 2006
Last updated in NPPESJanuary 31, 2017

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Group practice Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance — 115 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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