Provider Demographics
NPI:1144621798
Name:MORGAN, ALLISON LORENE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:LORENE
Last Name:MORGAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9787
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98909-0787
Mailing Address - Country:US
Mailing Address - Phone:509-575-8255
Mailing Address - Fax:
Practice Address - Street 1:406 S 30TH AVE STE 206
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-3713
Practice Address - Country:US
Practice Address - Phone:509-509-5743
Practice Address - Fax:509-225-2705
Is Sole Proprietor?:No
Enumeration Date:2014-09-12
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA61096131363A00000X
SD0942363A00000X
AL1256363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2172817Medicaid