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Individual

DR. MICHAEL ROY MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
301 W POPLAR ST STE 210, WALLA WALLA, WA 99362-2800
(509) 897-5788
Mailing address
301 W POPLAR ST, WALLA WALLA, WA 99362-2858
(095) 897-8959
(095) 897-5788

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD61324152
WA
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
33095
CO
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
MD61324152
WA
225400000X
Rehabilitation Practitioner
G85748
CA

Other

Enumeration date
05/25/2005
Last updated
05/27/2025
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