Provider Demographics
NPI:1871828517
Name:MORRIS, WILLIAM FREDERIC (PMHNP, APRN-NP, DNP)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:FREDERIC
Last Name:MORRIS
Suffix:
Gender:M
Credentials:PMHNP, APRN-NP, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 70779
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97475-0137
Mailing Address - Country:US
Mailing Address - Phone:541-345-1722
Mailing Address - Fax:541-485-7049
Practice Address - Street 1:66 CLUB RD STE 160
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2439
Practice Address - Country:US
Practice Address - Phone:541-345-1722
Practice Address - Fax:541-485-7049
Is Sole Proprietor?:No
Enumeration Date:2009-10-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE47055163W00000X
OR099007862RN163W00000X
NE111069363LP0808X
OR201150058NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500642166Medicaid
OR500757466Medicaid
R176759Medicare UPIN