Provider Demographics
NPI:1497891451
Name:HALL, DEBORAH NICOLETTE (CADC)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:NICOLETTE
Last Name:HALL
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:DEBBIE
Other - Middle Name:N
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2995 RYAN DR SE STE 200
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-5157
Mailing Address - Country:US
Mailing Address - Phone:503-580-4557
Mailing Address - Fax:
Practice Address - Street 1:3325 HAROLD DR NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97305-1339
Practice Address - Country:US
Practice Address - Phone:503-363-2021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No175T00000XOther Service ProvidersPeer Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR02-11-39OtherCADC