Individual
CAROL NEFF MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, MSN
Contact information
Practice address
500 LILLY RD NE, OLYMPIA, WA 98506-5195
(253) 477-5114
(253) 477-5140
Mailing address
MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE, TACOMA, WA 98431-0001
(253) 477-5114
(253) 477-5140
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
244627
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2-44627
RN
TX
Enumeration date
05/13/2019
Last updated
05/13/2019
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