Individual
DR. NICHOLAS DAVID MORALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
9123 SE SAINT HELENS ST STE 100F, CLACKAMAS, OR 97015-6800
(503) 740-1971
(503) 771-2436
Mailing address
10117SE SUNNYSIDE RD., F1217, CLACKAMAS, OR 97015
(503) 740-1971
(503) 771-2436
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
201603282NP-PP
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1982051959
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500707281
—
OR
Enumeration date
05/19/2016
Last updated
11/14/2024
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