Active NPI
Elizabeth Moua
- Pharmacist
- Spokane, WA
National Provider Identifier
1114675873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH61422626
- Practice address
- 624 E Front Ave
Spokane, WA 99202-2139 - Phone
- (509) 626-9900
- Fax
- (509) 227-7070
- NPI assigned
- Mar 12, 2022
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PI-0013345 | OR | |
| Pharmacist | 183500000X | IR61252618 | WA | |
| Pharmacist | 183500000X | PH61422626 | WA | Primary |
Addresses
Primary practice location
624 E Front Ave
Spokane, WA 99202-2139
Mailing address
PO Box 421
Liberty Lake, WA 99019-0421
Phone (866) 747-2455
Other practice location 1
190 E Bannock St
Boise, ID 83712-6241
Phone (503) 484-5240
Other practice location 2
19610 SE 1st St
Camas, WA 98607-7472
Phone (360) 258-6221
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PI-0013345 | OR | MD | Pharmacist |
| IR61252618 | WA | MD | Pharmacist |
| PH61422626 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687737600000",
"number": "1114675873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 421",
"city": "LIBERTY LAKE",
"state": "WA",
"postal_code": "990190421",
"telephone_number": "866-747-2455",
"fax_number": "509-227-7070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "624 E FRONT AVE",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992022139",
"telephone_number": "509-626-9900",
"fax_number": "509-227-7070"
}
],
"practiceLocations": [
{
"address_1": "190 E Bannock St",
"address_purpose": "LOCATION",
"city": "Boise",
"state": "ID",
"postal_code": "837126241",
"country_code": "US",
"telephone_number": "503-484-5240",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "19610 SE 1st St",
"address_purpose": "LOCATION",
"city": "Camas",
"state": "WA",
"postal_code": "986077472",
"country_code": "US",
"telephone_number": "360-258-6221",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOUA",
"first_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-12",
"last_updated": "2023-06-26",
"certification_date": "2022-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "PI-0013345",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "IR61252618",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH61422626",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.