Moore, Michael D

Moore, Michael D is an individual health care provider with primary practice located at 2600 Martin Way E Ste C, Olympia WA 98506-4974. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Moore, Michael D can be contacted via phone (360) 357-7899.

Contact Information

Primary practice address
2600 Martin Way E Ste C Olympia WA 98506-4974
Phone: (360) 357-7899
Fax: (360) 357-6495
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1010 Washington

Profile Details

NPI number 1770560708
LBN Legal business name Moore, Michael D
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 30th, 2005
Last updated Mar 7th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770560708 NPPES
Washington Other 0149388 L & I
Washington Other 1326213992 L & I
Washington MEDICAID 2631703 L & I

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