Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 68396 | MT |
N | 207RC0000X | Internist - Cardiovascular Disease | MD20449 | ME |
Y | 207RC0000X | Internist - Cardiovascular Disease | MD60742078 | WA |
NPI | 1003041468 |
---|---|
Provider Name | Ms. Deirdre Marie Mooney |
First Address | Liberty Lake, WA 99019-0331 |
Second Address | Spokane, WA 99204-2339 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2009 |
Last Update Date | 27/02/2021 |