Provider Demographics
NPI:1730647975
Name:EDDINGTON, DALLAS (THW)
Entity Type:Individual
Prefix:MR
First Name:DALLAS
Middle Name:
Last Name:EDDINGTON
Suffix:
Gender:M
Credentials:THW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7303
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97303-0062
Mailing Address - Country:US
Mailing Address - Phone:971-719-2440
Mailing Address - Fax:
Practice Address - Street 1:565 UNION ST NE STE 100
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-2416
Practice Address - Country:US
Practice Address - Phone:971-719-2440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-06
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist