Individual
DANIELLE DIETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2645 PORTLAND RD NE STE 120, SALEM, OR 97301-0200
(503) 390-5637
(503) 393-3135
Mailing address
5325 SW HALL BLVD, BEAVERTON, OR 97005-0531
(503) 840-2396
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
A5655
OR
1041C0700X
Clinical Social Worker
Primary
L11004
OR
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
07/17/2020
Last updated
05/31/2022
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