Healthcare Provider Details

I. General information

NPI: 1508227448
Provider Name (Legal Business Name): CINDY M MOSBRUCKER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2016
Last Update Date: 11/02/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11505 BURNHAM DR STE #302
GIG HARBOR WA
98332
US

IV. Provider business mailing address

11505 BURNHAM DR STE #302
GIG HARBOR WA
98332
US

V. Phone/Fax

Practice location:
  • Phone: 253-313-5997
  • Fax: 253-313-5179
Mailing address:
  • Phone: 253-313-5997
  • Fax: 253-313-5179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number60016675
License Number StateWA

VIII. Authorized Official

Name: DR. CINDY MARIE MOSBRUCKER
Title or Position: OWNER
Credential: M.D.
Phone: 253-313-5997