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

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1508579889

Timothy Evan Moore is a Student in an Organized Health Care Education/Training Program in Lebanon, Oregon. Practices as a sole proprietor. Registered with an NPI since 2023.

In the registry since
2023
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Practice location Address checks out

200 Mullins Dr
Lebanon, OR 97355-3983
Phone: (541) 259-0235
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1508579889
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJanuary 2, 2023
Last updated in NPPESJanuary 2, 2023
Certification dateJanuary 1, 2023
Mailing address200 Mullins Dr, Lebanon, OR 97355-3983

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