Provider Demographics
NPI:1750722385
Name:MORONEY, LINDA DIANE (ARNP)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:DIANE
Last Name:MORONEY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24338 N MCKENZIE DR
Mailing Address - Street 2:
Mailing Address - City:RATHDRUM
Mailing Address - State:ID
Mailing Address - Zip Code:83858-7390
Mailing Address - Country:US
Mailing Address - Phone:509-496-2239
Mailing Address - Fax:855-828-3184
Practice Address - Street 1:1633 WESTLAKE AVE N
Practice Address - Street 2:SUITE 105
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-6227
Practice Address - Country:US
Practice Address - Phone:206-802-9533
Practice Address - Fax:866-675-1604
Is Sole Proprietor?:No
Enumeration Date:2013-07-11
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60391140363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily