Provider Demographics
NPI:1780485342
Name:CHANCE D. GALLO
Entity type:Organization
Organization Name:CHANCE D. GALLO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHANCE
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:GALLO
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:206-914-8382
Mailing Address - Street 1:1420 S MERIDIAN STE B
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98371-6914
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1420 S MERIDIAN STE B
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98371-6914
Practice Address - Country:US
Practice Address - Phone:206-914-8382
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty