Individual
KEONNA MOFFETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
2715 NACHES AVE SW, RENTON, WA 98057-2627
(206) 630-1680
(206) 630-1601
Mailing address
4302 S 122ND ST, TUKWILA, WA 98178-3437
(206) 725-0924
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW60608715
WA
Other
Enumeration date
11/30/2020
Last updated
04/15/2021
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