Provider Demographics
NPI:1285851717
Name:MORAN, ANNA M (OD)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:M
Last Name:MORAN
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 822
Mailing Address - Street 2:
Mailing Address - City:GLIDE
Mailing Address - State:OR
Mailing Address - Zip Code:97443-0822
Mailing Address - Country:US
Mailing Address - Phone:541-580-3388
Mailing Address - Fax:
Practice Address - Street 1:1370 NW GARDEN VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97471-1765
Practice Address - Country:US
Practice Address - Phone:541-580-3388
Practice Address - Fax:541-636-0293
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OROR3050AT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist