Organization
PUBLIC HOSPITAL DISTRICT NO 1 OF MASON COUNTY
Active
Organization
PUBLIC HOSPITAL DISTRICT NO 1 OF MASON COUNTY
Active
Other names
Shelton Orthopedics
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERIC MOLL CEO (CHIEF EXECUTIVE OFFICER)
(360) 427-9554
Entity
Organization
Contact information
Practice address
939 MOUNTAIN VIEW DR, SUITE 130, SHELTON, WA 98584-4410
(360) 427-9549
(360) 427-3661
Mailing address
939 MOUNTAIN VIEW DR, SUITE 130, SHELTON, WA 98584-4410
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G000241100
GROUP MEDICARE PART B PTAN
WA
Enumeration date
01/16/2009
Last updated
09/19/2013
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