Organization
BRIDGE CITY COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NATHANAEL BAGLEY LPC (OWNER)
(503) 545-5329
Entity
Organization
Contact information
Practice address
712 SE HAWTHORNE BLVD, SUITE 100, PORTLAND, OR 97214-3538
(503) 545-5329
(503) 327-8005
Mailing address
712 SE HAWTHORNE BLVD, SUITE 100, PORTLAND, OR 97214-3538
(503) 545-5329
(503) 327-8005
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C2381
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500669729
—
OR
Enumeration date
10/19/2013
Last updated
04/13/2016
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