Healthcare Provider Details

I. General information

NPI: 1912609751
Provider Name (Legal Business Name): PHILLIP LEE MORRILL II DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2023
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 NE 139TH ST
VANCOUVER WA
98686-2742
US

IV. Provider business mailing address

1170 W 900 N
LAYTON UT
84041-7515
US

V. Phone/Fax

Practice location:
  • Phone: 360-397-1985
  • Fax: 360-604-1604
Mailing address:
  • Phone: 801-540-0835
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberOP61568513
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: