Provider Demographics
NPI:1356602551
Name:BLEICH, ERIC BRIAN
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:BRIAN
Last Name:BLEICH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22265 E WILD FERN LN
Mailing Address - Street 2:
Mailing Address - City:BRIGHTWOOD
Mailing Address - State:OR
Mailing Address - Zip Code:97011-8731
Mailing Address - Country:US
Mailing Address - Phone:503-544-6167
Mailing Address - Fax:
Practice Address - Street 1:22265 E WILD FERN LN
Practice Address - Street 2:
Practice Address - City:BRIGHTWOOD
Practice Address - State:OR
Practice Address - Zip Code:97011-8731
Practice Address - Country:US
Practice Address - Phone:503-544-6167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-04
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist