FISHERS LANDING PRIMARY CARE
NPI 1275295164
Family Medicine in Vancouver, WA

Q: What is L Katherine Moon's NPI number?

The NPI number for L Katherine Moon is 1275295164. It was assigned to this organization in the NPPES registry on October 8, 2021. The provider is doing business as Fishers Landing Primary Care.

Q: What is L Katherine Moon's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for L Katherine Moon was last updated on February 6, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 08, 2021CLIA 50D2255966 · Waiver

406 SE 131ST AVE STE C, VANCOUVER, WA 98683(360) 816-0277(360) 567-4004 Get Directions Write a Review

NPPES record last updated: February 6, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 6, 2022, Oct 8, 2021 (2 updates tracked since 2021).

On this page

About Fishers Landing Primary Care NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FISHERS LANDING PRIMARY CARE (NPI 1275295164) is a healthcare organization registered as a family medicine in Vancouver, Washington and active in the NPI registry since October 2021. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists L Katherine Moon, Owner, as its authorized official.

NPPES Registry Identity

NPI1275295164

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameL KATHERINE MOON

Location Address406 SE 131ST AVE STE CVancouver, WA 98683-4004

Mailing Address6715 Ne 63rd St Ste 436Vancouver, WA 98661-1980 · (360) 816-0277 · Fax (360) 567-4004

Phone(360) 816-0277

Fax(360) 567-4004

Organization SubpartYes

Authorized OfficialL Katherine MoonOwner · (360) 816-0277

Enumeration DateOctober 8, 2021

Last NPPES UpdateFebruary 6, 20222 updates tracked since enumeration

NPPES CertifiedFebruary 6, 2022

✔ NPI 1275295164 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

406 SE 131ST AVE STE C, Vancouver, WA 98683

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Other Names 1

Doing Business AsFishers Landing Primary Care

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., Regence BlueCross BlueShield of Oregon.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Fishers Landing Primary Care is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Fishers Landing Primary Care, which bills Medicare for the services this clinician delivers.

Clinician (1)

L Katherine Moon, ARNP, FNP,MSN

Nurse Practitioner

NPI 1518992494

406 SE 131ST AVE STE C
Vancouver, WA 98683

(360) 816-0277

✔ PECOSSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 50D2255966

Fishers Landing Primary Care · Vancouver, WA

Active · expires Apr 4, 2028

CLIA Number50D2255966

Laboratory TypeNp Office

Certificate Effective DateMarch 18, 2022

Certificate Expiration DateApril 4, 2028

Laboratory DirectorKatherine Moon

Laboratory Phone(360) 816-0277

Laboratory LocationFishers Landing Primary Care406 SE 164th Ave Ste C305, Vancouver, WA 98683

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is L Katherine Moon's NPI number?

The NPI number for L Katherine Moon is 1275295164. It was assigned to this organization in the NPPES registry on October 8, 2021. The provider is doing business as Fishers Landing Primary Care.

Where is L Katherine Moon located?

L Katherine Moon is located at 406 SE 131st Ave Ste C, Vancouver, WA 98683. The listed phone number is (360) 816-0277.

What is L Katherine Moon's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is L Katherine Moon enrolled in Medicare?

Yes. L Katherine Moon is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through L Katherine Moon?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to L Katherine Moon. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does L Katherine Moon hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 50D2255966) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does L Katherine Moon accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc. and Regence BlueCross BlueShield of Oregon list L Katherine Moon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for L Katherine Moon was last updated on February 6, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.