Individual
BLAIR MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
700 NE 87TH AVE, VANCOUVER, WA 98664-4896
(360) 882-2778
Mailing address
10413 NE 127TH AVE, VANCOUVER, WA 98682-2891
(360) 882-2778
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201041601RN
OR
163W00000X
Registered Nurse
Primary
RN60181311
WA
Other
Enumeration date
04/24/2026
Last updated
04/24/2026
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