Provider Demographics
NPI:1316306731
Name:FOSTER, MORGAN JEWEL
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:JEWEL
Last Name:FOSTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:KEITH
Other - Middle Name:STACEY
Other - Last Name:HART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17710 NE HALSEY ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97230-6734
Mailing Address - Country:US
Mailing Address - Phone:971-293-3468
Mailing Address - Fax:971-293-3469
Practice Address - Street 1:17710 NE HALSEY ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97230-6734
Practice Address - Country:US
Practice Address - Phone:971-293-3468
Practice Address - Fax:541-774-7979
Is Sole Proprietor?:No
Enumeration Date:2016-02-12
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator