Provider Demographics
NPI:1356309868
Name:BAUMAN, WENDY L (LPC, CADCI)
Entity Type:Individual
Prefix:MS
First Name:WENDY
Middle Name:L
Last Name:BAUMAN
Suffix:
Gender:F
Credentials:LPC, CADCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 SE MARRISON ST
Mailing Address - Street 2:SUITE 710
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214
Mailing Address - Country:US
Mailing Address - Phone:503-954-1525
Mailing Address - Fax:503-208-2765
Practice Address - Street 1:516 SE MARRISON ST
Practice Address - Street 2:SUITE 710
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214
Practice Address - Country:US
Practice Address - Phone:503-954-1525
Practice Address - Fax:503-208-2765
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR010701101YA0400X
ORC1699101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)