Healthcare Provider Details

I. General information

NPI: 1457019143
Provider Name (Legal Business Name): DOROTHY MORINITI MSN, RN, CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HANNAH MORINITI MSN, RN, CPNP-PC

II. Dates (important events)

Enumeration Date: 11/30/2021
Last Update Date: 12/09/2021
Certification Date: 12/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24850 SE STARK ST STE 150
GRESHAM OR
97030-8318
US

IV. Provider business mailing address

7320 SW 35TH AVE
PORTLAND OR
97219-1745
US

V. Phone/Fax

Practice location:
  • Phone: 503-491-0714
  • Fax:
Mailing address:
  • Phone: 503-201-6403
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number202113152NP-PP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: