Individual
K JASON BRUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
3425 13TH ST, BAKER CITY, OR 97814-1340
(541) 523-7400
(541) 523-4927
Mailing address
3425 13TH ST, BAKER CITY, OR 97814-1340
(541) 523-7400
(541) 523-4927
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
OR
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
19-QMHPC-00934
OR
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
C8091
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500719940
—
OR
Enumeration date
06/27/2016
Last updated
10/02/2025
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