Provider Demographics
NPI:1902020951
Name:MORGAN, DARA LEE (ARNP)
Entity Type:Individual
Prefix:MS
First Name:DARA
Middle Name:LEE
Last Name:MORGAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:DARA
Other - Middle Name:LEE
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:4700 POINT FOSDICK DR NW
Mailing Address - Street 2:STE 220
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335
Mailing Address - Country:US
Mailing Address - Phone:253-851-5121
Mailing Address - Fax:253-851-3059
Practice Address - Street 1:4700 POINT FOSDICK DR NW
Practice Address - Street 2:SUITE 220
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335
Practice Address - Country:US
Practice Address - Phone:253-851-5121
Practice Address - Fax:253-851-3059
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2017-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00070695163W00000X
WAAP30004526363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9623737Medicaid
WAP00474505Medicare PIN
G8869470Medicare PIN
WA9623737Medicaid