Provider Demographics
NPI:1992986319
Name:BAGLEY, NATALIE (LPC)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:BAGLEY
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 SE HAWTHORNE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-3538
Mailing Address - Country:US
Mailing Address - Phone:503-545-5329
Mailing Address - Fax:503-327-8005
Practice Address - Street 1:712 SE HAWTHORNE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-3538
Practice Address - Country:US
Practice Address - Phone:503-545-5329
Practice Address - Fax:503-327-8005
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-14
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC2381101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORC2381OtherOREGON PROFFESSIONAL COUNSELOR LISCENSE