Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003046517 |
---|---|
Provider Name | James Paul Bryant |
First Address | Portland, OR 97206-7546 |
Second Address | Portland, OR 97227-1196 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2009 |
Last Update Date | 17/12/2021 |