MEDICARE: DANIEL J MOON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RR0500X	Rheumatology Physician	MD60538616	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437410354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL J MOON MD

Provider Business Mailing Address
First Line	:	4033 TALBOT RD S STE 440
Second Line	:
City	:	RENTON
State	:	WA
Zip	:	98055-5767
Country	:	US
Telephone Number	:	425-690-1000
Fax Number	:

Provider Business Practice Location Address
First Line	:	4033 TALBOT RD S STE 440
Second Line	:
City	:	RENTON
State	:	WA
Zip	:	98055-5767
Country	:	US
Telephone Number	:	425-690-3494
Fax Number	:	425-690-9494

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2012
Last Update Date	:	12/26/2025

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