Healthcare Provider Details

I. General information

NPI: 1376013656
Provider Name (Legal Business Name): DARCY J MOYER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DARCY J ENGEL

II. Dates (important events)

Enumeration Date: 11/29/2018
Last Update Date: 11/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 E NORTH FOOTHILLS DR
SPOKANE WA
99207-2101
US

IV. Provider business mailing address

107 S DIVISION ST
SPOKANE WA
99202-1510
US

V. Phone/Fax

Practice location:
  • Phone: 509-838-4651
  • Fax:
Mailing address:
  • Phone: 509-838-4651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60312742
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: