Jacki L Moon is a Specialist in Lake Stevens, Washington. Jacki L Moon practices all healthcare services and medical treatments related to Specialist. The NPI Number for Jacki L Moon is 1629273008. The last update date is 2021-02-02.
Jacki L Moon's current location address is P.o. Box 1061, Lake Stevens, Washington. You can contact this provider via phone number 4253974900 and fax number 4253976900. The mailing address for Jacki L Moon is P.o. Box 1061, Lake Stevens, Washington. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jacki L Moon |
|---|---|
| Address | P.o. Box 1061, Lake Stevens, Washington |
| Phone Number | 4253974900 |
| Fax Number | 4253976900 |
| Sole Proprietor | Y |
| Credentials | LMT |
NPI Number Detail
| NPI Number | 1629273008 |
|---|---|
| Provider Enumeration Date | 2007-06-18 |
| Last Updated Date | 2021-02-02 |
Provider Mailing Address Detail
| Address | P.o. Box 1061 |
|---|---|
| City | Lake Stevens |
| State | Washington (WA) |
| Post Code | 98258 |
| Phone Number | 4253974900 |
| Fax Number | 4253976900 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | MA00004663 |
|
Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
|
Post Comment/ Review Below
What is the unique identification code assigned to Jacki L Moon by the Centers for Medicare & Medicaid Services?
The Jacki L Moon has been issued the NPI (National Provider Identifier) 1629273008. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you kindly provide the complete physical address where Jacki L Moon's facilities are geographically located?
The facilities of Jacki L Moon are physically situated at the following location: P.O. Box 1061, Lake Stevens, WA, 98258.
What is the Jacki L Moon's specialty and taxonomy code?
The Jacki L Moon's specialty is Specialist, and the corresponding taxonomy code is 174400000X.
On what date did the Jacki L Moon receive its 1629273008 assignment from the Centers for Medicare & Medicaid Services?
The Jacki L Moon was assigned its 1629273008 by the Centers for Medicare & Medicaid Services on 2007-06-18.
When was the information pertaining to Jacki L Moon most recently updated or revised?
The details related to Jacki L Moon, including its address, specialty, and other relevant information, were last updated or revised on 2021-02-02.