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Individual

MS. JANICE G. BRIDGEWATER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
1235 SE DIVISION #104, PORTLAND, OR 97202
(503) 888-9540
Mailing address
1235 SE DIVISION #104, PORTLAND, OR 97202
(503) 888-9540

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
3788
OR
101Y00000X
Counselor
Primary
L3788
OR

Other

Enumeration date
01/18/2007
Last updated
09/06/2022
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