Provider Demographics
NPI:1003697582
Name:LAYTON, ALISON
Entity type:Individual
Prefix:MS
First Name:ALISON
Middle Name:
Last Name:LAYTON
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ALISON
Other - Middle Name:
Other - Last Name:WADSWORTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:698 12TH ST SE STE 210
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-4010
Mailing Address - Country:US
Mailing Address - Phone:503-383-1248
Mailing Address - Fax:503-217-6526
Practice Address - Street 1:1650 SW 45TH PL
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97333-1768
Practice Address - Country:US
Practice Address - Phone:541-757-8068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-10
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
OR101YM0800X101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health