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General NPI Number Information
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NPI Number | 1396058186
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Entity Type | Individual
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Provider Name | RICHARD MOULE
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Gender | Male
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Dates
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Enumeration Date | 07/21/2010
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Last Update Date | 07/21/2010
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Provider Practice Location Address
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Address Line | 4308 76TH ST NE
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City | MARYSVILLE
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State | WA
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Zip | 98270-3720
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Country | US
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Telephone | 425-349-7309
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Fax |
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Provider Business Mailing Address
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Address Line | 2320 SAHALEE DR E
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City | SAMMAMISH
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State | WA
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Zip | 98074-6317
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Country | US
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Telephone | 425-260-0200
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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