L Katherine Moon

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

L KATHERINE MOON

Practice address

406 SE 131St Ave Ste C
Vancouver, WA 98683-4004

Phone

(360) 816-0277

Fax

(360) 567-4004

NPI assigned

Oct 8, 2021

Organization subpart

Yes

Parent organization

L KATHERINE MOONAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

L Katherine Moon, FNPNPI 1518992494

Title

Owner

Phone

(360) 816-0277

Specialties & licenses 1

Addresses

Other names 1

• Fishers Landing Primary Care Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Part of

L Katherine Moon

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• L Katherine Moon, ARNP, FNP,MSN

  • Family Nurse Practitioner
  • Vancouver, WA
  • NPI 1518992494
  Medicare reassignment Authorized official
• Lisa D Zylstra, PA-C

  • Medical Physician Assistant
  • Vancouver, WA
  • NPI 1821142738
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1633651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644105600000",
    "number": "1275295164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6715 NE 63RD ST STE 436",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986611980",
            "telephone_number": "360-816-0277",
            "fax_number": "360-567-4004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 SE 131ST AVE STE C",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986834004",
            "telephone_number": "360-816-0277",
            "fax_number": "360-567-4004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "L KATHERINE MOON",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "L KATHERINE MOON",
        "enumeration_date": "2021-10-08",
        "last_updated": "2022-02-06",
        "certification_date": "2022-02-06",
        "status": "A",
        "authorized_official_last_name": "MOON",
        "authorized_official_first_name": "L KATHERINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-816-0277",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fishers Landing Primary Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fishers Landing Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Viktor Kuznetsov, DNP
• Vikchai Tiger Ky, SUDPT
• Brittney Grace Kyle
• Kimberly J Kyro-Bello, PHARMD
• Kywina M Henderson Professional Advanced Practice Nursing Corporat
• Corinne Beth La Fors
• Todd Robert La Rock, D.O.
• Jaime Anne La Tona, LH61531731
• Labtran Clinical Laboratories, LLC
• Gregory Todd Lackey, DC

• Family Medicine Physician in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.