Organization
BRIDGES TO CHANGE
Active
Parent organization
BRIDGES TO CHANGE
Organization subpart
Yes
Provider details
NPI number
Legal business name
BRIDGES TO CHANGE
Authorized official
TRISTA KILDOW (SYSTEM ADMIN)
(503) 374-3730
Entity
Organization
Contact information
Practice address
7916 SE FOSTER RD STE 201, PORTLAND, OR 97206-4289
(503) 465-2749
Mailing address
PO BOX 16576, PORTLAND, OR 97292-0576
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
175T00000X
Peer Specialist
—
—
Other
Enumeration date
10/17/2023
Last updated
10/17/2023
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