Provider Demographics
NPI:1790043602
Name:BRIDGE, CATHERINE VAIL (LAC)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:VAIL
Last Name:BRIDGE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1017 MOLALLA AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-3772
Mailing Address - Country:US
Mailing Address - Phone:503-720-7980
Mailing Address - Fax:
Practice Address - Street 1:1017 MOLALLA AVE STE 2
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-3772
Practice Address - Country:US
Practice Address - Phone:503-766-4813
Practice Address - Fax:503-765-7308
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-27
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC217532171100000X, 171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist