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General NPI Number Information
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NPI Number | 1467579284
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Entity Type | Individual
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Provider Name | CORNELIA R. MOYNIHAN N.D., L.AC.
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Gender | Female
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Dates
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Enumeration Date | 03/25/2007
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Last Update Date | 08/08/2023
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Provider Practice Location Address
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Address Line | 2102 N ALDER ST
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City | TACOMA
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State | WA
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Zip | 98406-6637
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Country | US
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Telephone | 253-759-2300
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Fax | 253-759-2333
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Provider Business Mailing Address
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Address Line | 314 N G ST APT A2
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City | TACOMA
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State | WA
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Zip | 98403-2282
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Country | US
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Telephone | 253-250-2630
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Fax | 253-759-2333
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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 | 175F00000X
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Taxonomy Name | Naturopath
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License Number | NT00001473
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC00002814
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License Number State | WA
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