Individual
EASTON HALLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC II, QMHA II
Contact information
Practice address
1217 NE BURNSIDE RD STE 701, GRESHAM, OR 97030-5770
(503) 866-0877
(503) 771-2436
Mailing address
10117 SE SUNNYSIDE RD STE F, CLACKAMAS, OR 97015-7708
(503) 866-0877
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
24-07-20450
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
175T00000X
Peer Specialist
—
—
Other
Enumeration date
12/12/2023
Last updated
01/15/2025
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