MEDICARE: HIROMI T MULDOON

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	225700000X	Massage Therapist	MA60022327	WA

General Provider Information

NPI Number	:	1679734750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HIROMI T MULDOON

Provider Business Mailing Address
First Line	:	8418 26TH AVE SW
Second Line	:	UNIT A
City	:	SEATTLE
State	:	WA
Zip	:	98106-3251
Country	:	US
Telephone Number	:	206-245-8699
Fax Number	:

Provider Business Practice Location Address
First Line	:	2445 4TH AVE S
Second Line	:	SUITE 112
City	:	SEATTLE
State	:	WA
Zip	:	98134-1939
Country	:	US
Telephone Number	:	206-467-7202
Fax Number	:

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

Provider Enumeration Date	:	06/20/2008
Last Update Date	:	03/04/2009

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Directions to “ HIROMI T MULDOON ” Practice Location

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