Basic Information
| Provider Information | |||||||||
| NPI: | 1861031213 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SLOAN | ||||||||
| FirstName: | MORGAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9066 SE BULL RUN RD | ||||||||
| Address2: | |||||||||
| City: | CORBETT | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970199517 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 502 E BOONE AVE | ||||||||
| Address2: | |||||||||
| City: | SPOKANE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 99258 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5093284220 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/02/2020 | ||||||||
| LastUpdateDate: | 01/02/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/02/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LS0200X | 201140103RN | OR | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | School |
ID Information
| ID | Type | State | Issuer | Description | 201140103RN | 01 | OR | RN LICENSE | OTHER |