Individual
JENNIFER MOON MONIOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
360 LILLY RD NE, #A, OLYMPIA, WA 98506-5430
(360) 486-0640
(360) 486-0641
Mailing address
PSC 78 BOX 1654, APO, AP 96326-0017
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
28559
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0321478
L & I
WA
Enumeration date
10/25/2005
Last updated
01/06/2016
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