Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SULLY MOON, IP
Active Sole ProprietorSULLY MOON, IP is a Podiatric Surgery healthcare provider located in LIBERTY LAKE, Washington. NPI 1982326914 is currently active in the NPPES registry. Verify at CMS.
Podiatric Surgery · LIBERTY LAKE, WA
Registration Details
- NPI Number
- 1982326914
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 15, 2022 (3.9386086515156 yrs)
- Last Updated
- Sep 15, 2022
- Sole Proprietor
- Yes
Practice Information
- Address
-
1410 N CAUFIELD CTLIBERTY LAKE, WA, 990169433Browse WA providers · Browse ZIP 99016
- Phone
- 3605255996
- Primary Specialty
-
Podiatric Surgery
3747A0650X
Other Podiatric Surgery Providers in LIBERTY LAKE, WA
| Name | Credential | NPI |
|---|---|---|
| JAMIE LATTIN | — | 1538739008 |
| KELLI A TORRES | — | 1407683733 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.