MR. RAYMOND MORENO JR. (NPI# 1407314735) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407314735 |
| Entity Type | Individual |
| Full Name | MR. RAYMOND MORENO JR. |
| Credential | PA-C |
| Practice Address |
12911 120th Ave Ne Ste H210 Kirkland WA 98034 |
| Mailing Address |
12911 120th Ave Ne Ste G10 Kirkland WA 98034-3048 |
| Practice Telephone | 4258234000 |
| Practice Fax Number | 4258213550 |
| Mailing Telephone | 2534816301 |
| Mailing Fax Number | 4254810516 |
| Enumeration Date | 2019-03-05 |
| Last Update Date | 2019-11-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA60999802 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 9324 175th Street Ct E, Puyallup, WA 983754019 | 2062767307 | |
| 14841 179th Ave Se Ste 330, Monroe, WA 982721127 | 3607943300 | 3607946610 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154323103 | Raymond G Moreno | Internal Medicine | 2225 Us Highway 41 N, Tifton, GA 31794-2749 | 2005-06-02 |
| 1134614522 | Raymond Anthony Moreno | Behavior Technician | 612 S Myrtle Ave Ste 100, Monrovia, CA 91016-3406 | 2018-06-27 |
| 1104341528 | Raymond Seth Moreno | Counselor | 1003 S Beacon St, San Pedro, CA 90731-4324 | 2017-08-07 |
| 1851717912 | Raymond Moreno | Nurse Practitioner | 800 Peakwood Dr Ste 5d, Houston, TX 77090-2903 | 2014-03-13 |
| 1679651129 | Raymond Moreno | Emergency Medicine | 9205 Sw Barnes Rd, Portland, OR 97225-6603 | 2006-11-01 |
| Street Address |
12911 120TH AVE NE STE H210 |
| City | KIRKLAND |
| State | WA |
| Zip Code | 98034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114022969 | Jamie R Antoine | Orthopaedic Surgery | 12911 120th Ave Ne Ste H210, Kirkland, WA 98034 | 2006-09-14 |
| 1225503873 | Vasile Oros | Physician Assistant | 12911 120th Ave Ne Ste H210, Kirkland, WA 98034-3065 | 2018-10-10 |
| 1568808970 | Edward K Jung | Orthopaedic Surgery | 12911 120th Ave Ne Ste H210, Kirkland, WA 98034-3065 | 2013-05-13 |
| 1821140054 | Duong H. Tran | Physician Assistant | 12911 120th Ave Ne Ste H210, Kirkland, WA 98034 | 2007-01-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578116596 | Rachel Bowers | Behavior Technician | 1335 Northeast 122nd Way, Suite 105, Kirkland, WA 98034 | 2019-07-18 |
| 1740841048 | Kristina Louise Inghram | Behavior Technician | 11415 Ne 128th St., Suite 40, Kirkland, WA 98034 | 2019-06-26 |
| 1053978064 | Matthew A. Bagnulo, Dds, Ps | Dentist | 11830 Ne 128th St., #202, Kirkland, WA 98034 | 2019-05-24 |
| 1629568928 | Stephanie Michalko | Optometrist | 11800 Ne 128th St Ste 110, Kirkland, WA 98034 | 2018-05-14 |
| 1952800013 | Heath Family Counseling LLC | Marriage & Family Therapist | 12025 115th Ave. Ne, Building D, Ste 200, Kirkland, WA 98034 | 2018-02-05 |
| 1891202834 | Barbara Josephine Gorham | Counselor | 2025 115th Ave Ne, Bldg D, #200, Kirkland, WA 98034 | 2017-12-29 |
| 1548782915 | Eleanor Hollis Wall | Counselor | 14340 102nd Ave Ne, Kirkland, WA 98034 | 2017-07-07 |
| 1457885212 | Peter Schoonmaker | Hospitalist | 12040 Ne 128th Street, Ms105, Kirkland, WA 98034 | 2017-04-18 |
| 1780124370 | Rebecca Managan | Advanced Practice Midwife | 12303 Ne 130th Ln Ste Coral225, Kirkland, WA 98034 | 2017-03-01 |
| 1669821104 | Winter Gonzalez | Counselor | 11720 97th Ln Ne Apt A411, Kirkland, WA 98034 | 2016-06-06 |
| Find all providers in zip 98034 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073990651 | Laura Skanse | Physician Assistant | 12303 Ne 130th Ln #500, Kirkland, WA 98034 | 2015-05-02 |
| 1740335066 | Surgery Suite Specialist, LLC. | Physician Assistant | 9701 Ne 120th Pl, Kirkland, WA 98034-4275 | 2007-01-25 |
| 1225503873 | Vasile Oros | Physician Assistant | 12911 120th Ave Ne Ste H210, Kirkland, WA 98034-3065 | 2018-10-10 |
| 1326406224 | Gerome Medinaceli Gepigon | Physician Assistant | 12039 Ne 128th St Ste 500, Kirkland, WA 98034-3029 | 2016-02-05 |
| 1265776470 | Garrett D. Gray | Physician Assistant | 12911 120th Ave Ne, Suite H-210, Kirkland, WA 98034-3027 | 2012-11-12 |
| 1558552505 | Eastside Fusion, LLC. | Physician Assistant | 9701 Ne 120th Pl, Kirkland, WA 98034-4275 | 2007-08-06 |
| 1114059987 | Jack W Romano | Physician Assistant | 9701 Ne 120th Pl, Kirkland, WA 98034-4275 | 2007-03-09 |
| 1881724524 | Susan Ann Chiappetta-romano | Physician Assistant | 9701 Ne 120th Pl, Kirkland, WA 98034-4275 | 2007-03-06 |
| 1821140054 | Duong H. Tran | Physician Assistant | 12911 120th Ave Ne Ste H210, Kirkland, WA 98034 | 2007-01-17 |
| 1356420475 | Nancy Corbett | Physician Assistant | 12303 Ne 130th Ln, Suite 520, Kirkland, WA 98034-3099 | 2006-11-02 |
| Find all providers in KIRKLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.