Beverly Moua, PHARMD

Primary specialty

Ambulatory Care PharmacistTaxonomy code 1835P2201X

License

PH60754789 Issued in WA

Practice address

207 E Stanley St
Granite Falls, WA 98252-8480

Phone

(360) 691-7778

NPI assigned

Oct 11, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1507680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507680000000",
    "number": "1881104297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 123RD AVE SE",
            "city": "SNOHOMISH",
            "state": "WA",
            "postal_code": "982905511",
            "telephone_number": "608-520-9148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 E STANLEY ST",
            "city": "GRANITE FALLS",
            "state": "WA",
            "postal_code": "982528480",
            "telephone_number": "360-691-7778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUA",
        "first_name": "BEVERLY",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-11",
        "last_updated": "2017-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "WA",
            "license": "PH60754789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Care Pharmacist in Granite Falls, WA
• Providers in Granite Falls, WA by specialty
• Ambulatory Care Pharmacist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2017; 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.