Individual
KATHLEEN ELIZABETH MOUDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
9911 N NEVADA ST, SPOKANE, WA 99218-1298
(509) 626-9430
(509) 227-7070
Mailing address
PO BOX 421, LIBERTY LAKE, WA 99019-0421
(509) 252-1900
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA10003530
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8345936
—
WA
Enumeration date
04/06/2006
Last updated
06/18/2021
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