Provider Demographics
NPI:1144423344
Name:BRYSON, NATHAN EDWARD (MSW)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:EDWARD
Last Name:BRYSON
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4842 SW SCHOLLS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-1630
Mailing Address - Country:US
Mailing Address - Phone:503-841-6401
Mailing Address - Fax:
Practice Address - Street 1:4842 SW SCHOLLS FERRY RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-1630
Practice Address - Country:US
Practice Address - Phone:503-841-6401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2019-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR64031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical