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General NPI Number Information
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NPI Number | 1053512954
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Entity Type | Individual
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Provider Name | DANIEL R FOSTER MSW CSWA QMHP
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Gender | Male
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Dates
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Enumeration Date | 05/29/2007
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Last Update Date | 06/29/2022
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Provider Practice Location Address
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Address Line | 4760 PORTLAND RD NE
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City | SALEM
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State | OR
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Zip | 97305-1760
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Country | US
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Telephone | 503-378-5952
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Fax |
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Provider Business Mailing Address
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Address Line | 2602 IMPERIAL DR NW
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City | ALBANY
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State | OR
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Zip | 97321-1697
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Country | US
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Telephone | 541-981-1606
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | A13296
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License Number State | OR
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