Individual
DALLAS DELAGRANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDP
Contact information
Practice address
1044 11TH AVE, LONGVIEW, WA 98632-2506
(360) 575-3316
Mailing address
PO BOX 2429, LONGVIEW, WA 98632-8486
(360) 575-8331
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60538325
WA
1041C0700X
Clinical Social Worker
SC61275777
WA
Other
Enumeration date
02/19/2014
Last updated
05/02/2022
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