Individual provider · Type 1 NPI

Bruce Moberg

Licensed Practical Nurse · Lakewood, WA

NPI number 1740879667 Active

Practice location

9720 S Tacoma Way
Lakewood, WA 98499-4456

Mailing address

15 Oregon Ave Ste 308
Tacoma, WA 98409-7462

Specialties and licenses

TaxonomyCodeLicense
Licensed Practical Nurse Primary 164W00000XLP60105633 (WA)

Licensed Practical Nurse: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

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About NPI 1740879667

Bruce Moberg's National Provider Identifier is 1740879667, issued on Jan 14, 2021. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Lakewood, WA. The record was last updated on Jan 14, 2021.