Individual
DOMINIQUE DALLMAYR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5404 N MONTANA AVE, PORTLAND, OR 97217-4557
(503) 327-5740
Mailing address
10033 NE SKIDMORE ST, PORTLAND, OR 97220-3569
(503) 327-5740
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L2851
OR
Other
Enumeration date
01/18/2018
Last updated
01/18/2018
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