MICHAEL D MOORE OD PS INC (NPI# 1326213992) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326213992 |
| Entity Type | Organization |
| Organization Name | MICHAEL D MOORE OD PS INC |
| Practice Address |
2600 Martin Way E Ste C Olympia WA 98506-4974 |
| Practice Telephone | 3603577899 |
| Practice Fax Number | 3603576495 |
| Mailing Telephone | 3603577899 |
| Mailing Fax Number | 3603576495 |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2008-10-30 |
| Authorized Official Name | MICHAEL D MOORE (OWNER/PRESIDENT) |
| Authorized Official Telephone | 3603577899 |
| Authorized Official Credential | OD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 1010 | WA | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | L & I | 0149388 | 01 |
| WA | 2631703 | 05 | |
| DEA | MM1253765 | 01 | |
| NPI | 1770560708 | 01 |
| Street Address |
2600 MARTIN WAY E STE C |
| City | OLYMPIA |
| State | WA |
| Zip Code | 98506-4974 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770560708 | Michael D Moore | Optometrist | 2600 Martin Way E, Ste C, Olympia, WA 98506-4974 | 2005-12-30 |
| 1972911311 | Bobbi Jo Epperson | Acupuncturist | 2600 Martin Way E, Olympia, WA 98506-4974 | 2014-07-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477185460 | Chloe Harper | Technician, Other | 3443 Lilly Rd Se, Ste B, Olympia, WA 98506 | 2020-02-07 |
| 1912543539 | Jessica Marie Radakovich | Licensed Practical Nurse | 3426 Mary Elder Rd, Olympia, WA 98506 | 2019-11-19 |
| 1669014973 | Arlene Josephine Adams | Registered Nurse | 413 Lily Rd Ne, Olympia, WA 98506 | 2019-10-09 |
| 1861999120 | Debra Delores Barker | Licensed Practical Nurse | 3710 South Bay Rd Ne, Olympia, WA 98506 | 2018-04-12 |
| 1801304431 | Michelle Warner | Nurse Practitioner | 205 Lilly Rd Ne Ste A1, Olympia, WA 98506 | 2018-01-17 |
| 1396258364 | Institute for Family Development | Community/Behavioral Health | 204 Quince St. Ne, Suite 200, Olympia, WA 98506 | 2017-11-13 |
| 1083137715 | Cameron Kunkel | Specialist/Technologist | 2512 20th Ave Ne, Olympia, WA 98506 | 2017-07-25 |
| 1184144768 | Trevor Shane Kwan | Family Medicine | 525 Lilly Road Ne, Olympia, WA 98506 | 2017-06-23 |
| 1073043212 | Michael H Harburg | Behavior Technician | 3857 Martin Way Ne, Olympia, WA 98506 | 2017-06-19 |
| 1780114371 | Priscilla Kangyang Jadu | Counselor | 3857 Martin Way E., Olympia, WA 98506 | 2017-06-15 |
| Find all providers in zip 98506 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649571118 | Brian Paul Finley | Optometrist | 3612 Wesley Dr Nw, Olympia, WA 98502-3746 | 2010-11-15 |
| 1386836591 | Van B. Ly | Optometrist | 319 7th Ave Se, Suite #101, Olympia, WA 98501-1325 | 2007-08-11 |
| 1811015688 | Richard Duane Hehn | Optometrist | 651 Sleater Kinney Se, Suite 1300, Olympia, WA 98503 | 2007-03-27 |
| 1205961836 | Kornmesser Optometry Clinic Inc Ps | Optometrist | 1405 Harrison Ave Nw Ste 101, Olympia, WA 98502-5327 | 2007-02-23 |
| 1881754182 | Dr. Kimberly Carr-yeates, O.d., P.s. | Optometrist | 625 Black Lake Blvd Sw Ste 369, Olympia, WA 98502-8606 | 2006-12-11 |
| 1275609463 | Ben Harold Wong Jr. | Optometrist | 1940 Black Lake Blvd Sw, Olympia, WA 98512-5651 | 2006-11-28 |
| 1851402085 | Kenneth Douglas Common | Optometrist | 625 Black Lake Blvd Sw, Suite #110, Olympia, WA 98502-5066 | 2006-08-31 |
| 1407963770 | Reid I Mamiya | Optometrist | 115 New View Ct Ne, Olympia, WA 98506-5250 | 2006-08-24 |
| 1508894007 | Susan M Dini | Optometrist | 2939 Benjamin Ct Se, Olympia, WA 98501-4807 | 2006-06-30 |
| 1770560708 | Michael D Moore | Optometrist | 2600 Martin Way E, Ste C, Olympia, WA 98506-4974 | 2005-12-30 |
| Find all providers in OLYMPIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.