Healthcare Provider Details

I. General information

NPI: 1790692762
Provider Name (Legal Business Name): LEAH ELIZABETH HAYNES BRESSMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21237 SE GOLDEN MARKET LN
BEND OR
97702-3651
US

IV. Provider business mailing address

21237 SE GOLDEN MARKET LN
BEND OR
97702
US

V. Phone/Fax

Practice location:
  • Phone: 503-313-8882
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberR8912
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: