Individual
LAVENA MORGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6535 SE 34TH AVE, PORTLAND, OR 97202-8205
(503) 983-5413
Mailing address
6535 SE 34TH AVE, PORTLAND, OR 97202-8205
(503) 983-5413
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
MD21448
OR
207V00000X
Obstetrics & Gynecology Physician
Primary
MD61090693
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
151319
—
OR
01
—
R141736
MEMBER'S PROVIDER TRANSACTION ACCESS NUMBER (PTAN)
OR
Enumeration date
06/14/2005
Last updated
12/29/2020
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