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General NPI Number Information
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NPI Number | 1538074638
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Entity Type | Individual
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Provider Name | CHAD EDWARD DICKSON
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Gender | Male
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Dates
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Enumeration Date | 08/14/2026
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Last Update Date | 08/14/2026
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Provider Practice Location Address
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Address Line | 10700 SW BEAVERTON HILLSDALE HWY BLDG 1
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City | BEAVERTON
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State | OR
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Zip | 97005-3019
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Country | US
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Telephone | 503-641-1475
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Fax |
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Provider Business Mailing Address
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Address Line | 5028 NE 13TH AVE
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City | PORTLAND
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State | OR
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Zip | 97211-5080
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Country | US
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Telephone | 510-616-8604
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 6574532
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License Number State | OR
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