Provider Demographics
NPI:1164141560
Name:MORGAN, DARLA NICOL (OTD)
Entity Type:Individual
Prefix:MISS
First Name:DARLA
Middle Name:NICOL
Last Name:MORGAN
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 W C AVE
Mailing Address - Street 2:
Mailing Address - City:LA CENTER
Mailing Address - State:WA
Mailing Address - Zip Code:98629-9511
Mailing Address - Country:US
Mailing Address - Phone:360-975-8704
Mailing Address - Fax:
Practice Address - Street 1:13413 NE LEROY HAGEN MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-5967
Practice Address - Country:US
Practice Address - Phone:360-604-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-26
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61340141225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics