Individual
MS. CARMEN MARIA MORALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
5050 NE HOYT ST, SUITE 240, PORTLAND, OR 97213-2991
(503) 215-6480
(503) 215-6469
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01433
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500605153
—
OR
01
—
P00726514
RR MEDICARE
OR
Enumeration date
01/30/2009
Last updated
10/13/2021
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