Basic Information
| Provider Information | |||||||||
| NPI: | 1841407251 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SALAZ | ||||||||
| FirstName: | JOSELYN | ||||||||
| MiddleName: | DAWN | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MS, PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 940 ORCHARDVIEW AVE NW | ||||||||
| Address2: | |||||||||
| City: | SALEM | ||||||||
| State: | OR | ||||||||
| PostalCode: | 973041962 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5039990825 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1675 WINTER ST NE | ||||||||
| Address2: | |||||||||
| City: | SALEM | ||||||||
| State: | OR | ||||||||
| PostalCode: | 973017152 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5035850351 | ||||||||
| FaxNumber: | 5035850212 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/16/2007 | ||||||||
| LastUpdateDate: | 01/20/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/20/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | C2238 | OR | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.