Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kahlil Ethan Wilson-Moore

Individual provider Peer Specialist · NPI 1972170306

Kahlil Ethan Wilson-Moore is a Peer Specialist in Spokane, Washington. Licensed in Washington. Registered with an NPI since 2021.

Licensed in
WA
In the registry since
2021
Specialties on file
3
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

107 S Division St
Spokane, WA 99202-1510
Phone: (509) 838-4651
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Counselor (primary) Taxonomy 101Y00000X · Licence GC61187844 (WA)
Peer Specialist Taxonomy 175T00000X
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1972170306
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 4, 2021
Last updated in NPPESJune 24, 2021
Certification dateJune 24, 2021

Other providers in Spokane