Individual
TIMOTHY MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
825 SE BISHOP BLVD STE 200, PULLMAN, WA 99163-5537
(509) 332-2517
(509) 334-9247
Mailing address
825 SE BISHOP BLVD STE 200, PULLMAN, WA 99163-5537
(509) 332-2517
(509) 334-9247
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
MD00025084
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8131435
—
WA
Enumeration date
06/29/2006
Last updated
07/09/2007
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