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Individual

SEAN MOON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1520 KELLY PL STE 234, WALLA WALLA, WA 99362-8607
(509) 575-4084
Mailing address
626 SE 4TH ST, COLLEGE PLACE, WA 99324-1317
(509) 386-7474

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
RN61058757
WA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP70039106
WA

Other

Enumeration date
08/02/2020
Last updated
04/29/2026
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