Provider Demographics
NPI:1447282207
Name:MOORE, LINDA Y (MD)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:Y
Last Name:MOORE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:INTEL HEALTH FOR LIFE CENTER
Mailing Address - Street 2:2501 NE CENTURY BLVD. RA3
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-5506
Mailing Address - Country:US
Mailing Address - Phone:971-214-8422
Mailing Address - Fax:
Practice Address - Street 1:INTEL HEALTH FOR LIFE CENTER
Practice Address - Street 2:2501 NE CENTURY BLVD. RA3
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-5506
Practice Address - Country:US
Practice Address - Phone:971-214-8422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD15675174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR029913Medicaid
OR029913Medicaid
ORE95800Medicare UPIN