| Doctor Name: | DUSTIN JOEL MOON |
| NPI Number: | 1174774822 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.T. |
| License Number: | 5786 |
| Business Practice Address: | 1717 Ne 2nd Street Redmond, OR - 977568249 |
| Business Phone Number: | 5415042350 |
| Business Fax Number: | 5419237550 |
| Mailing Address: | 805 Sw Industrial Way, Ste 3 BEND |
| State: | OR |
| Postal Code: | 977021093 |
| Phone Number: | 5415852529 |
| Fax Number: | 5415852536 |
| NPI Enumeration Date: | 09/30/2008 |
| NPI Last Update Date: | 03/14/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 5786 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |