Healthcare Provider Details

I. General information

NPI: 1093638918
Provider Name (Legal Business Name): MALLORY TURNER MSW, QMHP-R, NBC-HWC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3180 CENTER ST NE STE 2274
SALEM OR
97301-4532
US

IV. Provider business mailing address

3160 CENTER ST NE
SALEM OR
97301-4530
US

V. Phone/Fax

Practice location:
  • Phone: 503-588-5288
  • Fax:
Mailing address:
  • Phone: 503-588-5288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License NumberA-3508669
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: