Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | MD60267444 | WA |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 2006-00248 | NC |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | MD60267444 | WA |
NPI | 1619940087 |
---|---|
Provider Name | Dr. Cynthia Ann Moffet |
First Address | Mount Vernon, WA 98274-4127 |
Second Address | Mount Vernon, WA 98274-4126 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2006 |
Last Update Date | 20/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H12132 | (02) |