Individual
VICTORIA MORIMOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
120 N COMMERCE AVE, FRONT ROYAL, VA 22630-2660
(540) 635-0800
(540) 635-0801
Mailing address
3181 SW SAM JACKSON PARK RD, HAROLD SCHNITZER DIABETES, MAIL CODE OP05-DC, PORTLAND, OR 97239-3098
(503) 494-1226
(503) 494-4781
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110008070
VA
363AM0700X
Medical Physician Assistant
0110008070
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8101855
—
NC
Enumeration date
02/15/2006
Last updated
10/25/2022
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