Healthcare Provider Details

I. General information

NPI: 1295197887
Provider Name (Legal Business Name): KATIE C MORIOKA WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2016
Last Update Date: 11/21/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

YELLOWHAWK TRIBAL HEALTH CENTER 46314 TIMINE WAY
PENDLETON OR
97801
US

IV. Provider business mailing address

YELLOWHAWK TRIBAL HEALTH CENTER PO BOX 160
PENDLETON OR
97801
US

V. Phone/Fax

Practice location:
  • Phone: 541-966-9830
  • Fax: 541-278-4597
Mailing address:
  • Phone: 541-966-9830
  • Fax: 541-278-4584

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number201601590NP-PP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: