Provider Demographics
NPI:1427297944
Name:MORRISSEY, PATRICK (DDS)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:MORRISSEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17437 BOONES FERRY RD
Mailing Address - Street 2:BUILDING B, SUITE 400
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-6201
Mailing Address - Country:US
Mailing Address - Phone:503-699-6699
Mailing Address - Fax:503-699-7676
Practice Address - Street 1:17437 BOONES FERRY RD
Practice Address - Street 2:BUILDING B, SUITE 400
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-6201
Practice Address - Country:US
Practice Address - Phone:503-699-6699
Practice Address - Fax:503-699-7676
Is Sole Proprietor?:No
Enumeration Date:2009-02-05
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD7762122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist