1992398259 NPI number — MOSER SERVICES, INC.

Table of content: MRS. NICOLE LYNN TYLER RN (NPI 1497988695)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992398259 NPI number — MOSER SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MOSER SERVICES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992398259
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/18/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4317 NE THURSTON WAY
Provider Second Line Business Mailing Address:
SUITE 230
Provider Business Mailing Address City Name:
VANCOUVER
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98662-5808
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-891-1506
Provider Business Mailing Address Fax Number:
360-891-1510

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4317 NE THURSTON WAY
Provider Second Line Business Practice Location Address:
SUITE 230
Provider Business Practice Location Address City Name:
VANCOUVER
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98662-5808
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-891-1506
Provider Business Practice Location Address Fax Number:
360-891-1510
Provider Enumeration Date:
02/18/2021

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CARDENAS
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
ANTHONY
Authorized Official Title or Position:
REGIONAL BUSINESS DEV.
Authorized Official Telephone Number:
425-577-3442

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)