Provider Demographics
NPI:1912878216
Name:MORALES, RAQUEL GARCIA (INTERN)
Entity type:Individual
Prefix:MS
First Name:RAQUEL
Middle Name:GARCIA
Last Name:MORALES
Suffix:
Gender:F
Credentials:INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:528 COTTAGE ST NE STE 401
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-3861
Mailing Address - Country:US
Mailing Address - Phone:503-583-8537
Mailing Address - Fax:503-343-3331
Practice Address - Street 1:528 COTTAGE ST NE STE 401
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-3861
Practice Address - Country:US
Practice Address - Phone:503-583-8537
Practice Address - Fax:503-343-3331
Is Sole Proprietor?:No
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program