Provider Demographics
NPI:1891459053
Name:ROBERTSON, DILLON (MA, RA)
Entity Type:Individual
Prefix:
First Name:DILLON
Middle Name:
Last Name:ROBERTSON
Suffix:
Gender:M
Credentials:MA, RA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7340 SW HUNZIKER RD STE 102
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-2303
Mailing Address - Country:US
Mailing Address - Phone:032-985-0075
Mailing Address - Fax:503-718-5855
Practice Address - Street 1:7340 SW HUNZIKER RD STE 102
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-2303
Practice Address - Country:US
Practice Address - Phone:971-533-3329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-25
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional