Jacki L. Moon, LMT

Specialist · Lake Stevens, WA

Individual Active NPI

NPI number 1629273008

Practice location

10519 20TH St. SE
Suite # 1
Lake Stevens, WA 98258
Phone
(425) 397-4900
Fax
(425) 397-6900

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NPI record

NPI
1629273008
Entity type
Individual (Type 1)
Enumeration date
June 18, 2007
Last updated
February 2, 2021
Certified
February 2, 2021
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Specialist Primary 174400000X MA00004663 WA

Mailing address

P.O. Box 1061
Lake Stevens, WA 98258
Phone
(425) 397-4900
Fax
(425) 397-6900

About Jacki Moon

Jacki L. Moon, LMT is a healthcare provider registered in the NPI registry with the primary taxonomy Specialist (code 174400000X). The practice location is 10519 20TH St. SE, Suite # 1, Lake Stevens, WA 98258. The NPI number 1629273008 was assigned on June 18, 2007 and the record was last updated on February 2, 2021.

Jacki Moon lists a license in the registry: #MA00004663 (WA) for Specialist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Jacki L. Moon, LMT?

The NPI number is 1629273008.

What is the phone number of Jacki Moon?

The phone number listed for the practice location is (425) 397-4900.

Where is Jacki Moon located?

10519 20TH St. SE, Suite # 1, Lake Stevens, WA 98258.

What is the taxonomy code for Jacki Moon?

The primary taxonomy code is 174400000X – Specialist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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