Healthcare Provider Details

I. General information

NPI: 1992626659
Provider Name (Legal Business Name): DALLIN PARKINSON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

845 MCKINLEY AVE
POCATELLO ID
83201-4952
US

IV. Provider business mailing address

120 W SIPHON RD APT 4
CHUBBUCK ID
83202-2006
US

V. Phone/Fax

Practice location:
  • Phone: 208-235-6800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: