Provider Demographics
NPI:1164980629
Name:MORERA, DEBORAH (COMM HEALTH WORKER)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:MORERA
Suffix:
Gender:F
Credentials:COMM HEALTH WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 SW MADISON AVE STE 113
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97333-4757
Mailing Address - Country:US
Mailing Address - Phone:541-752-7220
Mailing Address - Fax:
Practice Address - Street 1:257 SW MADISON AVE STE 113
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97333-4757
Practice Address - Country:US
Practice Address - Phone:541-752-7220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-04
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker