Healthcare Provider Details

I. General information

NPI: 1508838780
Provider Name (Legal Business Name): LANNA MERCEDES MOORE-DUNCAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9601 STEILACOOM BLVD SW
LAKEWOOD WA
98498-7213
US

IV. Provider business mailing address

2422 S 224TH ST APARTMENT 104
DES MOINES WA
98198-6643
US

V. Phone/Fax

Practice location:
  • Phone: 253-582-8900
  • Fax:
Mailing address:
  • Phone: 206-653-7215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMA60478
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberMD00046495
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: