Individual
KELLY E MOENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
12606 E MISSION AVE, SPOKANE VALLEY, WA 99216-3421
(509) 838-6709
(509) 835-4058
Mailing address
12606 E MISSION AVE, SPOKANE VALLEY, WA 99216-3421
(509) 838-6709
(509) 835-4058
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP30001703
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004376000
—
ID
01
—
244046
DEPT OF LABOR AND INDUSTRIES
WA
05
—
9647041
—
WA
Enumeration date
08/26/2006
Last updated
09/12/2009
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