Organization
EASTER SEALS OREGON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. J DAVID CHEVEALLIER (PRESIDENT/CEO)
(503) 228-5108
Entity
Organization
Contact information
Practice address
290 MOYER LN NW, SALEM, OR 97304-3822
(503) 370-8990
(503) 363-4214
Mailing address
5757 SW MACADAM AVE, PORTLAND, OR 97239-3765
(503) 228-5108
(503) 228-1352
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
269076
—
OR
Enumeration date
02/13/2006
Last updated
09/11/2025
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