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Individual

DENNIS STALLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSW

Contact information

Practice address
3710 SW US VETERANS HOSPITAL RD, PORTLAND, OR 97239-2964
(503) 220-8262
(503) 273-5285
Mailing address
4206 SE 33RD AVE, PORTLAND, OR 97202-3439
(503) 220-8262
(503) 273-5285

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S26143
TX

Other

Enumeration date
09/03/2006
Last updated
07/08/2007
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