DR. NICHOLE LYNN MOGHARREBAN (NPI# 1013270180) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013270180 |
| Entity Type | Individual |
| Full Name | DR. NICHOLE LYNN MOGHARREBAN |
| Credential | PSYD |
| Practice Address |
9040 Jackson Ave Madigan Army Medical Center Tacoma WA 98431-0001 |
| Mailing Address |
300 Pasteur Dr Stanford CA 94305-2200 |
| Practice Telephone | 2539682252 |
| Mailing Telephone | 6507234000 |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2019-12-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | 30199 | CA | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PY60446879 | WA | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 300 Pasteur Dr, Stanford, CA 94305 | 6507234000 |
| Street Address |
9040 JACKSON AVE MADIGAN ARMY MEDICAL CENTER |
| City | TACOMA |
| State | WA |
| Zip Code | 98431-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386641694 | Muhammad Ayub | Family Medicine | 9040 Jackson Ave Madigan Army Medical Center, Tacoma, WA 98431-0001 | 2005-06-30 |
| 1699399659 | Haywood Maurice Mcrae | Social Worker | 9040 Jackson Ave Madigan Army Medical Center, Tacoma, WA 98431-0001 | 2020-06-04 |
| 1710490677 | Layne Jensen | Registered Nurse | 9040 Jackson Ave Madigan Army Medical Center, Attn: Mchj-clq-c, Tacoma, WA 98431-1100 | 2017-11-14 |
| 1437679636 | Michael John Zylstra | General Practice | 9040 Jackson Ave Madigan Army Medical Center, Tacoma, WA 98431-5001 | 2017-06-20 |
| 1033666581 | Diana Monzon | Registered Nurse | 9040 Jackson Ave Madigan Army Medical Center, Attn: Mchj-clq-c, Tacoma, WA 98413-1100 | 2016-09-01 |
| 1639541717 | Justin Schafer | Physician Assistant | 9040 Jackson Ave Madigan Army Medical Center, Tacoma, WA 98431-0001 | 2015-10-28 |
| 1164768008 | Kelly Avant | Physical Therapist | 9040 Jackson Ave Madigan Army Medical Center, Tacoma, WA 98431-0001 | 2012-12-21 |
| 1891058145 | Kristopher M Peters | Dermatology | 9040 Jackson Ave Madigan Army Medical Center, Tacoma, WA 98431-4613 | 2012-06-21 |
| 1992066765 | Matthew Steven Reece | Anesthesiology | 9040 Jackson Ave Madigan Army Medical Center, Tacoma, WA 98431-5001 | 2012-06-07 |
| 1477824068 | Cynthia Benton Lee | Nurse Anesthetist, Certified Registered | 9040 Jackson Ave Madigan Army Medical Center, Tacoma, WA 98431-2010 | 2012-01-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497212260 | Catrina Renee Grugin | Registered Nurse | Madigan Army Medical Center, Attn Mchj-clq-c, 9040 Jackson Ave, Tacoma, WA 98431 | 2019-02-27 |
| 1801307681 | Bianca Gomez | Dental Assistant | Bldg 9900 Lincoln Street, Jblm, WA 98431 | 2017-10-19 |
| 1184133225 | Darren Paris | Registered Nurse | Madigan Army Medical Center 9040 Jackson Ave., Attn: Mchj-clq-c, Tacoma, WA 98431 | 2017-09-20 |
| 1922538206 | Sarah Frerichs | Dentist | Madigan Annex, Second Floor, Bldg. 9900, Apo, AA 98431 | 2017-06-19 |
| 1740736495 | Misty Hill | Dental Assistant | 9119 Mill Park Ave, Tacoma, WA 98431 | 2016-08-31 |
| 1336695535 | Jacqueline D Massouda | Dentist | Jblm Dentac, 9900 Lincoln Sreet, 2nd Floor, Apo, AA 98431 | 2016-08-28 |
| 1609239375 | Gregg V Palmer | Licensed Practical Nurse | 17th and C Street, Bldg 11582, Tacoma, WA 98431 | 2016-03-31 |
| 1114323904 | Deanna Sheets | Nurse Practitioner | 911 Mil Park Ave, Tacoma, WA 98431 | 2014-11-06 |
| 1679905434 | Austin William Schaar | Dentist | Building 9900, 2nd Floor, Tacoma, WA 98431 | 2013-08-05 |
| 1518209758 | Maurice Ibrahim Khayat | Internal Medicine | 9040 Jackson Ave Mche-qd (creds), Tacoma, WA 98431 | 2013-03-26 |
| Find all providers in zip 98431 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760097497 | Laetitia Geoffroy-dallery | Psychologist | 6425 S Cheyenne St, Tacoma, WA 98409-1633 | 2020-09-10 |
| 1780199125 | Christopher Edwards | Psychologist | 1500 N Warner St Stop 1035, Tacoma, WA 98416-1035 | 2017-12-07 |
| 1184134314 | Colleen Rustad | Psychologist | 3224 6th Ave, Tacoma, WA 98406-5902 | 2017-10-02 |
| 1174983316 | Troy Allen Robison | Psychologist | 9600 Veterans Dr Sw # A-116atc, Tacoma, WA 98493-5000 | 2016-03-01 |
| 1447618053 | Llc Courage 2b | Psychologist | 1764 N James St, Tacoma, WA 98406-1508 | 2016-02-10 |
| 1326415472 | Sean Morrison | Psychologist | 708 Broadway Ste 170, Tacoma, WA 98402-3778 | 2015-08-25 |
| 1386981850 | Larry D Pruitt | Psychologist | 9933 W Hayes St Madigan Anx, Joint Base Lewis Mcchord, Tacoma, WA 98431-0001 | 2013-01-03 |
| 1740541945 | Quyen Bich Nguyen | Psychologist | 4301 S Pine St Ste 30-07, Tacoma, WA 98409-9123 | 2012-06-04 |
| 1518245679 | Christmas Covell | Psychologist | 2105 N 30th St, Tacoma, WA 98403-3318 | 2011-07-22 |
| 1790089001 | Maurice Patrick O'connor | Psychologist | 321 E 25th St, Tacoma, WA 98421-1300 | 2010-12-29 |
| Find all providers in TACOMA | ||||
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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.