Individual
EDWARD BALLESTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1875 JACKSON ST SE, ALBANY, OR 97322-4051
(541) 791-6481
Mailing address
1875 JACKSON ST SE, ALBANY, OR 97322-4051
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3920
OR
Other
Enumeration date
02/19/2025
Last updated
02/19/2025
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