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

Individual provider Clinical Social Worker · NPI 1790093730

Melody Lynn Moore, PA-C, LCSW is a Clinical Social Worker in Olympia, Washington. Works from 2 locations. Licensed in North Carolina and Washington.

Licensed in
NC, WA
In the registry since
2010
Specialties on file
4
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

3624 Ensign Rd NE Ste F
Olympia, WA 98506-5114
Phone: (360) 634-8949
Fax: (360) 634-8234
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2135 New Walkertown Rd, Winston Salem, NC 27101-3420 — (336) 723-7904

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 61505595 (WA)
Clinical Social Worker Taxonomy 1041C0700X · Licence C006993 (NC)
Physician Assistant Taxonomy 363A00000X · Licence 0010-13458 (NC)
Clinical Social Worker Taxonomy 1041C0700X · Licence 61505595 (WA)

Record details

NPI number1790093730
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C , LCSW
Sole proprietorNo
NPI enumeratedSeptember 23, 2010
Last updated in NPPESNovember 18, 2025
Certification dateNovember 18, 2025

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