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Organization
L KATHERINE MOON
Active
Organization
L KATHERINE MOON
Active
Parent organization
L KATHERINE MOON
Other names
Fishers Landing Primary Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
L KATHERINE MOON
Authorized official
L KATHERINE MOON FNP (OWNER)
(360) 816-0277
Entity
Organization
Contact information
Practice address
406 SE 131ST AVE STE C, VANCOUVER, WA 98683-4004
(360) 816-0277
(360) 567-4004
Mailing address
6715 NE 63RD ST STE 436, VANCOUVER, WA 98661-1980
(360) 816-0277
(360) 567-4004
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
10/08/2021
Last updated
02/06/2022
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