Individual
JILL DALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
58646 MCNULTY WAY, SAINT HELENS, OR 97051-6210
(503) 397-5211
Mailing address
58646 MCNULTY WAY, P. O. BOX 1234, SAINT HELENS, OR 97051-6210
(503) 397-5211
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
20-CPS-010
OR
Other
Enumeration date
07/31/2007
Last updated
07/31/2007
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