Individual
ANNE FRASER BAGWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
1020 SW TAYLOR ST STE 560, PORTLAND, OR 97205-2533
(503) 226-1213
Mailing address
1020 SW TAYLOR ST STE 560, PORTLAND, OR 97205-2533
(503) 226-1213
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CO161
OR
Other
Enumeration date
03/04/2007
Last updated
07/08/2007
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