Individual
BRYAN ROBERT EASLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
704 MAIN ST STE 302, OREGON CITY, OR 97045-1842
(971) 386-3407
(503) 723-6653
Mailing address
PO BOX 16756, PORTLAND, OR 97292-0756
(971) 386-3407
(503) 208-2596
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
OR
175T00000X
Peer Specialist
Primary
15-CRM-049
OR
Other
Enumeration date
01/30/2012
Last updated
06/26/2017
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