Provider Demographics
NPI:1043659006
Name:MORLEY, ROY LIBUEL (CRNA)
Entity type:Individual
Prefix:
First Name:ROY
Middle Name:LIBUEL
Last Name:MORLEY
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:OLIBIA
Other - Middle Name:ROY
Other - Last Name:MORLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:PO BOX 255
Mailing Address - Street 2:
Mailing Address - City:BAYVIEW
Mailing Address - State:ID
Mailing Address - Zip Code:83803-0255
Mailing Address - Country:US
Mailing Address - Phone:208-683-1178
Mailing Address - Fax:
Practice Address - Street 1:342 FAIRVIEW ST
Practice Address - Street 2:
Practice Address - City:SILVERTON
Practice Address - State:OR
Practice Address - Zip Code:97381-1917
Practice Address - Country:US
Practice Address - Phone:503-873-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-22
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID54123163W00000X, 367500000X
ORAPRN-CRNA10019120367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse