Provider Demographics
NPI:1598401317
Name:MORGAN, AMBER M
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:M
Last Name:MORGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3155 SE BELMONT ST APT 2
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-4090
Mailing Address - Country:US
Mailing Address - Phone:503-901-7119
Mailing Address - Fax:
Practice Address - Street 1:3155 SE BELMONT ST APT 2
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-4090
Practice Address - Country:US
Practice Address - Phone:503-901-7119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-05
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC208630171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist