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Active NPI 1629273008 Individual Practitioner Female Practitioner

Jacki L Moon , LMT

Specialist • Lake Stevens, WA

Professional Overview & Biography Verified Profile Summary

Jacki Moon, LMT is a registered healthcare professional specializing in Specialist in Lake Stevens, WA. Practice services are available at 10519 20TH ST. SE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

10519 20th St. Se
Suite # 1

Lake Stevens, WA 98258

Telephone 4253974900
Fax 4253976900
Associated Practice Facility / Clinic
🏢 Edmark Chiropractic Pllc Facility NPI 1144699190

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Lake Stevens, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 35.4 Yrs
Regional Practice Density
10 Specialists

Practicing in Lake Stevens, WA (2751 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2021-02-02
Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License WA MA00004663

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
NPI 1790803468

Doctor of Chiropractic

NPI 1881929016

Doctor of Naturopathic Medicine, Licensed Acupuncturist

Esther Edwards

Massage Therapist

NPI 1952878589

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location February 02, 2021

Registered at 10519 20TH ST. SE, SUITE # 1, LAKE STEVENS, WA 98258 (Tel: 4253974900)

👤
Provider Name / Credentials Updated February 02, 2021

Recorded as JACKI MOON, LMT

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 10910 LAKE VIEW DR, LAKE STEVENS, WA 982589572 (Tel: 4255027710)

📍
Updated Business Mailing Address July 08, 2007

Registered at P.O. BOX 1061, LAKE STEVENS, WA 98258 (Tel: 4255017710)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as JACKI MOON, M.M.P.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Specialist (License #MA00004663 in WA)

🟢
Initial NPI Registration & Enumeration June 18, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1629273008
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 18, 2007
Last Update: February 02, 2021
Sole Proprietor: Yes

Mailing Address

P.o. Box 1061

Lake Stevens, WA 98258

Phone: 4253974900

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.