Healthcare Provider Details

I. General information

NPI: 1750480539
Provider Name (Legal Business Name): AARON C. MOY RC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 9TH AVE BOX 359735
SEATTLE WA
98104-2420
US

IV. Provider business mailing address

325 9TH AVE BOX 359735
SEATTLE WA
98104-2420
US

V. Phone/Fax

Practice location:
  • Phone: 206-341-4612
  • Fax: 206-341-4614
Mailing address:
  • Phone: 206-341-4612
  • Fax: 206-341-4614

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberRC00042213
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCP00004144
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: