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General NPI Number Information
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NPI Number | 1508020314
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Entity Type | Individual
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Provider Name | MICHAEL J MOSLEY M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/11/2008
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Last Update Date | 08/30/2013
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Provider Practice Location Address
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Address Line | 407 14TH AVE SE
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City | PUYALLUP
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State | WA
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Zip | 98372-3770
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Country | US
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Telephone | 253-697-1962
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Fax |
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Provider Business Mailing Address
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Address Line | 407 14TH AVE SE
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City | PUYALLUP
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State | WA
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Zip | 98372-3770
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Country | US
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Telephone | 253-697-1962
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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 | 207QH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Family Medicine) Physician
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License Number | 38958
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | MD60380187
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 207QH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Family Medicine) Physician
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License Number | MD60380187
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD60380187
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License Number State | WA
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