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Individual

KRISTEN SEAN MOE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
325 9TH AVE, SEATTLE, WA 98104-2420
(206) 731-3229
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 520-5700

Taxonomy

Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
MD00029686
WA
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
MD00029686
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0231580
L&I
WA
05
1497898969
WA
01
8326
INTERNAL ID-MOTOR VEHICLE ID
Enumeration date
02/15/2007
Last updated
11/08/2017
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