Mooney, Kathleen Marie

Mooney, Kathleen Marie is an individual health care provider with primary practice located at 9300 Se 91St Ave Suite 200, Happy Valley OR 97086-3749. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Mooney, Kathleen Marie can be contacted via phone (503) 261-1171.

Contact Information

Primary practice address
9300 Se 91St Ave Suite 200 Happy Valley OR 97086-3749
Phone: (503) 261-1171
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD00038960 Washington
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD27072 Oregon

Profile Details

NPI number 1043393655
LBN Legal business name Mooney, Kathleen Marie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 24th, 2006
Last updated Feb 22nd, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043393655 NPPES
Washington MEDICAID 8257081

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