Organization
NORTHWEST PODIATRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDON MOODLEY DPM (SOLE MEMBER)
(305) 323-2882
Entity
Organization
Contact information
Practice address
11711 NE 12TH ST, STE 1-B, BELLEVUE, WA 98005-2461
(425) 453-1598
Mailing address
19633 93RD PL NE, BOTHELL, WA 98011-2380
(305) 323-2882
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
603091158
WA
Other
Enumeration date
04/29/2011
Last updated
04/29/2011
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