Individual
LISA MOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1035 244TH AVE NE, REDMOND, WA 98074-3486
(425) 466-9931
Mailing address
6788 138TH AVE NE APT 628, REDMOND, WA 98052-9562
(425) 883-9116
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN60107790
WA
Other
Enumeration date
09/08/2014
Last updated
09/08/2014
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