Physician Compare National (NPI:1912096967)

HEALTHCARE PROVIDER: KANDI SUE MOLLER OD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1912096967
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4880734367
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20200226000540
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MOLLER
	Individual professional last name
Provider First Name	KANDI
	Individual professional first name
Provider Middle Name	S
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	PACIFIC UNIVERSITY - COLLEGE OF OPTOMETRY
	Individual professional's medical school
Graduation Year	1999
	Individual professional's medical school graduation year
Primary Specialty	OPTOMETRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	4735 POINT FOSDICK DR NW
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 300
	Group Practice or individual's line 2 address
City	GIG HARBOR
	Group Practice or individual's city
State	WA
	Group Practice or individual's state
Zip Code	983352314
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y