Provider Demographics
NPI:1457019143
Name:MORINITI, DOROTHY (MSN, RN, CPNP-PC)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:
Last Name:MORINITI
Suffix:
Gender:F
Credentials:MSN, RN, CPNP-PC
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:
Other - Last Name:MORINITI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSN, RN, CPNP-PC
Mailing Address - Street 1:7320 SW 35TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-1745
Mailing Address - Country:US
Mailing Address - Phone:503-201-6403
Mailing Address - Fax:
Practice Address - Street 1:24850 SE STARK ST STE 150
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-8318
Practice Address - Country:US
Practice Address - Phone:503-491-0714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-30
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202113152NP-PP363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics