Gomez Moreno, Amy
Gomez Moreno, Amy is an individual health care provider with primary practice located at 500 Se Washington Ave , Chehalis WA 98532-3058. She recently has only one registered license in Nursing Service Related Providers / Nurse's Aide, which is considered as her primary health care specialty. Gomez Moreno, Amy can be contacted via phone (360) 748-4776.Contact Information
Primary practice address
500 Se Washington Ave
Chehalis WA 98532-3058
Phone: (360) 748-4776
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Related Providers / Nurse's Aide | 376K00000X | NC60871841 | Washington |
Profile Details
| NPI number | 1124600770 |
|---|---|
| LBN Legal business name | Gomez Moreno, Amy |
| Credentials | Certified in Nursing Administration (CNA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 23rd, 2021 |
| Last updated | Apr 23rd, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124600770 | NPPES |
| Washington | MEDICAID | 2077844 |
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