MEDICARE: DR. MILAN SHANNON MOORE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	MD00039784	WA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	GAB21356	OTHER	WA	MEDICARE LEGACY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	8275349	OTHER	WA	DSHS
4	148355	OTHER	WA	LABOR & INDUSTRIES
5	5918MO	OTHER	WA	REGENCE

General Provider Information

NPI Number	:	1063490290
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MILAN SHANNON MOORE MD

Provider Business Mailing Address
First Line	:	PO BOX 368
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98507-0368
Country	:	US
Telephone Number	:	360-491-8439
Fax Number	:	360-491-6328

Provider Business Practice Location Address
First Line	:	3901 CAPITAL MALL DR SW STE A
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98502-8654
Country	:	US
Telephone Number	:	360-786-8990
Fax Number	:	360-786-9010

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2006
Last Update Date	:	01/20/2024

Similar Medicare Providers

1992709604 — DR. GARY LEE WOOD MD
Practice Location Address:

3900 CAPITAL MALL DR SW
OLYMPIA, WA
98502-8654

Practice Phone: 360-754-5858
Practice Fax:

1639178361 — MR. DANIEL ARTHUR CHURCHES P.T.
Practice Location Address:

3901 CAPITAL MALL DR SW , STE D
OLYMPIA, WA
98502-8654

Practice Phone: 360-709-6221
Practice Fax: 360-359-4727

1538169701 — DR. AMY BALETTIE WINTER D.P.M.
Practice Location Address:

3901 CAPITAL MALL DR SW STE A
OLYMPIA, WA
98502-8654

Practice Phone: 360-570-3460
Practice Fax:

1316933666 — LAURINDA RAE ELGIN RNC MS NNP PNP FNP
Practice Location Address:

3900 CAPITOL MALL DR SW , CAPITAL MEDICAL CENTER - WOMENS' SERVICES
OLYMPIA, WA
98502-8654

Practice Phone: 360-704-4714
Practice Fax: 360-956-1547

1265494546 — GARY DOOLITTLE MD
Practice Location Address:

3901 CAPITAL MALL DR SW
OLYMPIA, WA
98502-8654

Practice Phone: 360-709-6230
Practice Fax:

1841258639 — MULTICARE HEALTH SYSTEM
Practice Location Address:

3900 CAPITAL MALL DR SW
OLYMPIA, WA
98502-8654

Practice Phone: 360-754-5858
Practice Fax:

Directions to “ DR. MILAN SHANNON MOORE MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.