Randy Scott Moffatt, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD00004017 Issued in WA

Practice address

605 E Holland Ave
Suite 200
Spokane, WA 99218-2225

Phone

(509) 838-2531

NPI assigned

Mar 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323648000000",
    "number": "1750359659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3649",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992203649",
            "telephone_number": "509-838-2531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 E HOLLAND AVE",
            "address_2": "SUITE 200",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992182225",
            "telephone_number": "509-838-2531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOFFATT",
        "first_name": "RANDY",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2011-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-100091",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00004017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aditi Dhakar Modi, M.D.
• Barbara L Moe, MPT
• Jordan Michael Moe, CTRS
• Katerina Elise Moeller
• Kelly Marie Moffatt, O.D.
• Moffitt Children'S Dentistry
• Jason Rusk Moffitt, DDS
• Rebecca Moffitt, LMP
• Maria Mogavero, LMT
• Katherine Quinn Mogensen, ARNP/FAMILY NURSE PR

• Optometrist in Spokane, WA
• Providers in Spokane, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2011; 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.