Provider Demographics
NPI:1760869523
Name:BACHMAN, GARRETT TAYLOR (LCSW)
Entity Type:Individual
Prefix:MR
First Name:GARRETT
Middle Name:TAYLOR
Last Name:BACHMAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 MAIN ST STE 203
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-1830
Mailing Address - Country:US
Mailing Address - Phone:971-389-7218
Mailing Address - Fax:
Practice Address - Street 1:511 MAIN ST STE 203
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-1830
Practice Address - Country:US
Practice Address - Phone:971-389-7218
Practice Address - Fax:503-386-2587
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-30
Last Update Date:2023-11-01
Deactivation Date:2022-01-22
Deactivation Code:
Reactivation Date:2022-02-21
Provider Licenses
StateLicense IDTaxonomies
ORL108621041C0700X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health