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THREE MOON CLINIC
NPI 1346598034
Non-Pharmacy Dispensing Site in Kent, WA

Active since August 28, 2012
19625 62ND AVE S, C-104, KENT, WA 98032(206) 838-3878 Get Directions Write a Review

NPPES record last updated: October 5, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Three Moon Clinic NPPES

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

THREE MOON CLINIC (NPI 1346598034) is a healthcare organization registered as a non-pharmacy dispensing site in Kent, Washington and active in the NPI registry since August 2012. The organization lists Jennifer A. Mccollum, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1346598034
Entity TypeOrganization
Primary Taxonomy332900000X
Legal Business NameGEM MAGIC HEALING, INC
Location Address19625 62ND AVE S, C-104Kent, WA 98032-1103
Mailing Address2980 N Beverly Glen Cir, Suite 100Los Angeles, CA 90077-1726 · (310) 474-9809 · Fax (888) 431-8819
Phone(206) 838-3878
Organization SubpartYes
Authorized OfficialJennifer A. MccollumMedical Director · (206) 838-3879
Enumeration DateAugust 28, 2012
Last NPPES UpdateOctober 5, 2015
✔ NPI 1346598034 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers
Taxonomy Code332900000X
Definition
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
19625 62ND AVE S, Kent, WA 98032
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Other Names 1

Doing Business AsThree Moon Clinic

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PERFORMANCE MODALITIES INC.
Durable Medical Equipment & Medical Supplies
19625 62ND AVE S, SUITE A 101
KENT, WA 98032
King County (253) 852-5612
EMPI
Durable Medical Equipment & Medical Supplies
19625 62ND AVE S
KENT, WA 98032
King County (253) 852-0078

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 Gem Magic Healing, Inc's NPI number?

The NPI number for Gem Magic Healing, Inc is 1346598034. It was assigned to this organization in the NPPES registry on August 28, 2012. The provider is doing business as Three Moon Clinic.

Where is Gem Magic Healing, Inc located?

Gem Magic Healing, Inc is located at 19625 62nd Ave S C-104, Kent, WA 98032. The listed phone number is (206) 838-3878.

What is Gem Magic Healing, Inc's specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

When was this NPI record last updated?

The NPPES record for Gem Magic Healing, Inc was last updated on October 5, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.