Basic Information
| Provider Information | |||||||||
| NPI: | 1831201490 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MORALES | ||||||||
| FirstName: | VICTOR | ||||||||
| MiddleName: | MANUEL | ||||||||
| NamePrefix: | MR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 29645 18TH AVE S | ||||||||
| Address2: | APT B303 | ||||||||
| City: | FEDERAL WAY | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980034285 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2062126781 | ||||||||
| FaxNumber: | 2535894042 | ||||||||
| Practice Location | |||||||||
| Address1: | 9900 VETERANS DR SW | ||||||||
| Address2: | A-116-CWT | ||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984930005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2535831634 | ||||||||
| FaxNumber: | 2535894042 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.