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Individual

DR. JOHN LINDSAY MOODY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
24961 THOMPSON DR, SEDRO WOOLLEY, WA 98284-8246
(360) 856-3115
Mailing address
4315 SHELBY CT, ANACORTES, WA 98221-8773
(360) 299-8303

Taxonomy

Speciality
Code
Description
License number
State
2084P0015X
Psychosomatic Medicine Physician
Primary
MD00016542
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1045046
DSHS PROVER NUMBER
WA
Enumeration date
04/10/2007
Last updated
07/08/2007
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