Active NPI
Jill Marie Moeller, LICSW
- Clinical Social Worker
- Issaquah, WA
National Provider Identifier
1023950409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LW70095398
- Practice address
- 751 NE Blakely Dr
Issaquah, WA 98029-6201 - Phone
- (425) 313-7000
- Fax
- (425) 394-7908
- NPI assigned
- Apr 7, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LW70095398 | WA | Primary |
Addresses
Primary practice location
751 NE Blakely Dr
Issaquah, WA 98029-6201
Mailing address
PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 320-4476
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2392154 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2021
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1801 Lind Ave SW
Renton, WA 98057-3339
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW-1582 | WY | MD | Clinical Social Worker |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Internal Medicine Physician
- Seattle, WA
- NPI 1689612954
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1775520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787875200000",
"number": "1023950409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 25608",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841250608",
"telephone_number": "206-320-4476"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "751 NE BLAKELY DR",
"city": "ISSAQUAH",
"state": "WA",
"postal_code": "980296201",
"telephone_number": "425-313-7000",
"fax_number": "425-394-7908"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOELLER",
"first_name": "JILL",
"middle_name": "MARIE",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-04-07",
"last_updated": "2026-08-28",
"certification_date": "2026-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WA",
"license": "LW70095398",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2392154",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Issaquah, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.