Individual
CAROLINE HANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
801 E WHEELER RD, MOSES LAKE, WA 98837-1820
(509) 765-5606
(509) 764-3244
Mailing address
660 S COOLIDGE ST, MOSES LAKE, WA 98837-1872
(509) 793-9715
(509) 764-3244
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OP61054636
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2182744
—
WA
Enumeration date
03/26/2018
Last updated
11/17/2022
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