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

Kenneth E Moore, PAC

Individual provider Physician Assistant · NPI 1013023407

Kenneth E Moore, PAC is a Physician Assistant in Walla Walla, Washington. Licensed in Washington. Registered with an NPI since 2006.

Licensed in
WA
In the registry since
2006
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

1313 N 13th Ave
Walla Walla, WA 99362-8817
Phone: (509) 200-2852
Fax: (509) 522-5899
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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 PA10003031 (WA)

Record details

NPI number1013023407
Entity typeIndividual (Type 1)
GenderMale
Credentials PAC
Sole proprietorNo
NPI enumeratedAugust 21, 2006
Last updated in NPPESJune 30, 2009
Mailing address615 University St, Walla Walla, WA 99362-2338

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