Provider Demographics
NPI:1235361650
Name:EWER, ALLISON PORTER
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:PORTER
Last Name:EWER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 CHURCH ST NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-7339
Mailing Address - Country:US
Mailing Address - Phone:503-930-0878
Mailing Address - Fax:503-364-9703
Practice Address - Street 1:1655 CAPITOL ST NE
Practice Address - Street 2:SUITE 13
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-7845
Practice Address - Country:US
Practice Address - Phone:503-930-0878
Practice Address - Fax:503-588-8167
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-18
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor