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| Type | Legal entity | [sources] | |||
|---|---|---|---|---|---|
| Name | Moomaw, Douglas E AuD | [sources] | |||
| Legal form | not available | [sources] | |||
| Country | United States | [sources] | |||
| ID Number | LD00001173 | [sources] | |||
| NPI | 1225187230 · 1700935707 | [sources] | |||
| Status | not available | [sources] | |||
| Last change | Last processed | First seen | |||
Medical providers terminated or excluded from Washington State's Medicaid program.
United States of America · HCA
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