Individual provider Active NPI

Justin Dallison, B.S.

  • Social Worker
  • Salem, OR
National Provider Identifier
1992183297
Registry record updated May 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
3737 Portland Rd NE
Salem, OR 97301-0311
Phone
(503) 390-2600
Fax
(503) 390-8562
NPI assigned
May 7, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

3737 Portland Rd NE
Salem, OR 97301-0311

Mailing address

PO Box 20400
Keizer, OR 97307-0400
Phone (503) 390-2600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor of Science

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1430956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430956800000",
    "number": "1992183297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20400",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973070400",
            "telephone_number": "503-390-2600",
            "fax_number": "503-390-8562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 PORTLAND RD NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973010311",
            "telephone_number": "503-390-2600",
            "fax_number": "503-390-8562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALLISON",
        "first_name": "JUSTIN",
        "credential": "B.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-07",
        "last_updated": "2015-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.