Provider Demographics
NPI:1083240832
Name:BOND, PAMELA LESLIE (LCSW, CADC-III)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:LESLIE
Last Name:BOND
Suffix:
Gender:
Credentials:LCSW, CADC-III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 NE 18TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-2822
Mailing Address - Country:US
Mailing Address - Phone:503-496-6839
Mailing Address - Fax:503-961-7911
Practice Address - Street 1:1712 NE SANDY BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-2851
Practice Address - Country:US
Practice Address - Phone:503-496-6839
Practice Address - Fax:503-961-7911
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-12
Last Update Date:2025-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL114591041C0700X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical