Individual provider Active NPI

Marila Moul, WHNP

  • Women's Health Nurse Practitioner
  • Puyallup, WA
National Provider Identifier
1609556141
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
AP61449979 Issued in WA
Practice address
702 30TH Ave SW
Puyallup, WA 98373-2756
Phone
(800) 769-0045
NPI assigned
Jul 19, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LW0102X AP61449979 WA Primary

Addresses

Primary practice location

702 30TH Ave SW
Puyallup, WA 98373-2756

Mailing address

1605 96TH Dr SE
Lake Stevens, WA 98258-3949
Phone (206) 409-8969

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

LicenseStateTypeSpecialty
AP61449979WAMDWomen's Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1689724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1609556141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 96TH DR SE",
            "city": "LAKE STEVENS",
            "state": "WA",
            "postal_code": "982583949",
            "telephone_number": "206-409-8969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 30TH AVE SW",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983732756",
            "telephone_number": "800-769-0045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUL",
        "first_name": "MARILA",
        "credential": "WHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-19",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "WA",
            "license": "AP61449979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.

Verify at the official NPI Registry.