SULLY MOON IP
NPI 1982326914
Technician - Attendant Care Provider in Liberty Lake, WA

Q: What is Sully Moon's NPI number?

The NPI number for Sully Moon is 1982326914. It was assigned to this individual provider in the NPPES registry on September 15, 2022. The provider is also known as Jareth Micheal Heilman.

Q: What is Sully Moon's specialty?

The primary specialty registered for this NPI is Technician, specializing in Attendant Care Provider, with taxonomy code 3747A0650X.

Q: When was this NPI record last updated?

The NPPES record for Sully Moon was last updated on September 15, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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 September 15, 2022

1410 N CAUFIELD CT, LIBERTY LAKE, WA 99016(360) 525-5996 Get Directions Write a Review

NPPES record last updated: September 15, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Sully Moon Ip NPPES

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

SULLY MOON IP (NPI 1982326914) is an individual attendant care provider provider in Liberty Lake, Washington and active in the NPI registry since September 2022.

NPPES Registry Identity

NPI1982326914

Entity TypeIndividualMale

Primary Taxonomy3747A0650X

Provider Legal NameSULLY MOONCredential: IP

Location Address1410 N CAUFIELD CTLiberty Lake, WA 99016-9433

Mailing Address1410 N Caufield CtLiberty Lake, WA 99016-9433 · (360) 525-5996

Phone(360) 525-5996

Sole ProprietorYes

Enumeration DateSeptember 15, 2022

NPPES CertifiedSeptember 15, 2022

✔ NPI 1982326914 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyTechnician · Attendant Care ProviderNursing Service Related Providers

Taxonomy Code3747A0650X

Definition

An individual who provides hands-on care, of both a supportive and health related nature, specific to the needs of a medically stable, physically handicapped individual. Supportive services are those that substitute for the absence, loss, diminution, or impairment of a physical or cognitive function. This service may include skilled or nursing care to the extent permitted by state law.

1410 N CAUFIELD CT, Liberty Lake, WA 99016

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Other Names 1

Former Name (1)Jareth Micheal Heilman

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 Sully Moon's NPI number?

The NPI number for Sully Moon is 1982326914. It was assigned to this individual provider in the NPPES registry on September 15, 2022. The provider is also known as Jareth Micheal Heilman.

Where is Sully Moon located?

Sully Moon practices at 1410 N Caufield Ct, Liberty Lake, WA 99016. The listed phone number is (360) 525-5996.

What is Sully Moon's specialty?

The primary specialty registered for this NPI is Technician, specializing in Attendant Care Provider, with taxonomy code 3747A0650X.

When was this NPI record last updated?

The NPPES record for Sully Moon was last updated on September 15, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.