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General NPI Number Information
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NPI Number | 1003046517
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Entity Type | Individual
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Provider Name | JAMES PAUL BRYANT LCSW, CADC 3
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Gender | Male
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Dates
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Enumeration Date | 07/17/2009
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Last Update Date | 12/17/2021
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Provider Practice Location Address
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Address Line | 3550 N INTERSTATE AVE
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City | PORTLAND
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State | OR
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Zip | 97227-1196
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Country | US
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Telephone | 503-964-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 6056 SE KNAPP ST
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City | PORTLAND
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State | OR
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Zip | 97206-7546
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Country | US
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Telephone | 503-577-3701
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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