Healthcare Provider Details

I. General information

NPI: 1265286124
Provider Name (Legal Business Name): BRIANA ROGER LPCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2024
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1306 NW HOYT ST STE 407
PORTLAND OR
97209-2787
US

IV. Provider business mailing address

1306 NW HOYT ST STE 407
PORTLAND OR
97209-2787
US

V. Phone/Fax

Practice location:
  • Phone: 971-407-3930
  • Fax: 888-515-7502
Mailing address:
  • Phone: 971-407-3930
  • Fax: 88-515-7502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: