Provider Demographics
NPI:1417358417
Name:DANIELMORAY CORPORATION
Entity Type:Organization
Organization Name:DANIELMORAY CORPORATION
Other - Org Name:DANIELMORAY CFS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:JEFFERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:971-227-7728
Mailing Address - Street 1:3801 NE 160TH AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98682-7492
Mailing Address - Country:US
Mailing Address - Phone:971-227-7728
Mailing Address - Fax:
Practice Address - Street 1:1000 NE 122ND AVE STE 25
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97230-2007
Practice Address - Country:US
Practice Address - Phone:971-227-7728
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-09
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0289253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1111048OtherOR PROVIDER NUMBER