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General NPI Number Information
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NPI Number | 1265675458
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Entity Type | Individual
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Provider Name | JESUCITA MORALES VASQUES
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Gender | Female
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Dates
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Enumeration Date | 04/17/2009
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Last Update Date | 11/08/2024
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Provider Practice Location Address
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Address Line | 182 SW ACADEMY ST
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City | DALLAS
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State | OR
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Zip | 97338-1996
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Country | US
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Telephone | 503-623-9289
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Fax | 503-831-1726
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Provider Business Mailing Address
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Address Line | PO BOX 20123
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City | KEIZER
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State | OR
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Zip | 97307-0123
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Country | US
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Telephone | 503-400-3550
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Fax | 503-837-0095
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | A2375
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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