Individual
DR. RICHARD BALLOU GALLAHER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
513 THAIN ROAD, LEWISTON, ID 83501-4140
(208) 743-0150
(208) 743-5358
Mailing address
513 THAIN ROAD, LEWISTON, ID 83501-4140
(208) 743-0150
(208) 743-5358
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY-202154
ID
103T00000X
Psychologist
PY00000815
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010147148
REGENCE BLUESHIELD
ID
05
—
041256289
—
WA
01
—
550867358
GENERAL INSURANCE NUMBER
ID
05
—
806984800
—
ID
01
—
Y0929
IDAHO BLUE CROSS
ID
Enumeration date
09/27/2006
Last updated
01/08/2013
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