Individual
DR. ROCKWELL G MOULTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
7301 45TH AVE NE, SEATTLE, WA 98115
(206) 522-6640
(206) 527-0147
Mailing address
PO BOX 25657, SEATTLE, WA 98165
(206) 522-6640
(206) 527-0147
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO00000450
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1098680
—
WA
01
—
374710001
GROUP HEALTH
WA
01
—
911730720
TAX ID
WA
01
—
MO6117
BLUE CROSS
WA
Enumeration date
10/02/2006
Last updated
07/20/2010
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