| NPI | 1346598034 |
|---|---|
| Doing Business As | THREE MOON CLINIC |
| Entity Type | Organization |
| Authorized Contact | JENNIFER A. MCCOLLUM Medical Director 206-838-3879 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2012-08-28 |
| Last Update Date | 2015-10-05 |