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General NPI Number Information
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NPI Number | 1407967722
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Entity Type | Individual
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Provider Name | ALEC JAY MOORMAN MD
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Gender | Male
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 03/09/2023
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Provider Practice Location Address
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Address Line | 1700 116TH AVE NE
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City | BELLEVUE
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State | WA
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Zip | 98004-3022
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Country | US
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Telephone | 206-680-0571
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 50095
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City | SEATTLE
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State | WA
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Zip | 98145-5095
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Country | US
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Telephone | 206-680-0571
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | MD60015391
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License Number State | WA
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