MEDICARE: BRIDGES TO CHANGE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326410986
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIDGES TO CHANGE

Provider Business Mailing Address
First Line	:	PO BOX 16576
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97292-0576
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7916 SE FOSTER RD STE 201
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97206-4289
Country	:	US
Telephone Number	:	503-465-2749
Fax Number	:	503-208-2596

Authorized Official
Title or Position	:	DIRECTOR OF TREATMENT SERVICES
Name	:	KATELYN BESSETTE
Credential	:	MA, LPC, CADCII
Telephone Number	:	503-858-7073

Provider Enumeration Date	:	10/22/2015
Last Update Date	:	06/19/2019

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Directions to “BRIDGES TO CHANGE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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