Individual
DR. JACK MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3700 MARTIN WAY E, #101, OLYMPIA, WA 98506-5052
(360) 456-2020
(360) 438-2577
Mailing address
3700 MARTIN WAY E, #101, OLYMPIA, WA 98506-5052
(360) 456-2020
(360) 438-2577
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD60240767
WA
Other
Enumeration date
12/13/2011
Last updated
12/13/2011
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