Individual
JUSTIN DALLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
B.S.
Contact information
Practice address
3737 PORTLAND RD NE, SALEM, OR 97301-0311
(503) 390-2600
(503) 390-8562
Mailing address
PO BOX 20400, KEIZER, OR 97307-0400
(503) 390-2600
(503) 390-8562
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
05/07/2015
Last updated
05/07/2015
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