Individual
JOHN A MOEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1001 FOURTH AVE PLAZA, STE 420, SEATTLE, WA 98154
(206) 320-3351
(206) 554-7787
Mailing address
PO BOX 84026, SEATTLE, WA 98124-8426
(206) 320-3351
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00024289
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1047018
—
WA
Enumeration date
10/26/2006
Last updated
10/08/2020
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