Healthcare Provider Details

I. General information

NPI: 1194262576
Provider Name (Legal Business Name): DESIREE FRANCENE MORRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DESIREE FRANCENE DOUCHETTE PTA

II. Dates (important events)

Enumeration Date: 01/24/2017
Last Update Date: 01/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11850 SW ALLEN BLVD
BEAVERTON OR
97005-4805
US

IV. Provider business mailing address

25117 SW PARKWAY AVE STE D
WILSONVILLE OR
97070-9697
US

V. Phone/Fax

Practice location:
  • Phone: 503-646-7164
  • Fax:
Mailing address:
  • Phone: 971-224-2040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number09437
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: