Healthcare Provider Details

I. General information

NPI: 1588444814
Provider Name (Legal Business Name): JORGE MORALES PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2023
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2275 COMMERCIAL ST
ASTORIA OR
97103-3327
US

IV. Provider business mailing address

PO BOX 190
YAKIMA WA
98907-0190
US

V. Phone/Fax

Practice location:
  • Phone: 503-338-4175
  • Fax:
Mailing address:
  • Phone: 509-865-2395
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH-0020250
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: