Dallas Delagrange, CDP is a
Counselor - Addiction (substance Use Disorder) based in Longview, Washington. Dallas Delagrange is licensed to practice in Washington (license number CP60538325) and his current practice location is
1044 11th Ave, Longview, Washington. He can be reached at his office (for appointments etc.) via phone at
(360) 575-3316.
NPI number for Dallas Delagrange is 1710302336 and his current mailing address is Po Box 2429, Longview, Washington. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1710302336.
Healthcare Provider's Profile
| Full Name | Dallas Delagrange |
|---|
| Gender | Male |
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| Speciality | Counselor - Addiction (substance Use Disorder) |
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| Location | 1044 11th Ave, Longview, Washington |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1710302336
- Provider Enumeration Date: 02/19/2014
- Last Update Date: 05/02/2022
Medical Identifiers
Medical identifiers for Dallas Delagrange such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1710302336 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1041C0700X | Social Worker - Clinical | SC61275777 (Washington) | Secondary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | CP60538325 (Washington) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dallas Delagrange is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dallas Delagrange, CDP
Po Box 2429,
Longview, WA 98632-8486
Ph: (360) 575-8331 | Dallas Delagrange, CDP
1044 11th Ave,
Longview, WA 98632-2506
Ph: (360) 575-3316 |
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