Individual
KURT W MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
3333 HARRISON AVE, SUITE 102, OLYMPIA, WA 98502
(360) 292-7245
(360) 292-7247
Mailing address
PO BOX 11009, CASCADE BILLING, OLYMPIA, WA 98508-1009
(360) 352-2037
(360) 352-0637
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00004067
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0204808
L & I
WA
05
—
8443756
—
WA
Enumeration date
08/29/2006
Last updated
01/18/2008
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