Provider Demographics
NPI:1780872465
Name:PERRY-BRINGMAN, HEIDE AMBER (MA LPC LMHC NCC)
Entity type:Individual
Prefix:MS
First Name:HEIDE
Middle Name:AMBER
Last Name:PERRY-BRINGMAN
Suffix:
Gender:F
Credentials:MA LPC LMHC NCC
Other - Prefix:MS
Other - First Name:HEIDE
Other - Middle Name:AMBER
Other - Last Name:PERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA LPC LMHC NCC
Mailing Address - Street 1:8816 SE MORRISON ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97216-1727
Mailing Address - Country:US
Mailing Address - Phone:360-241-0871
Mailing Address - Fax:
Practice Address - Street 1:2303 E BURNSIDE ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-1655
Practice Address - Country:US
Practice Address - Phone:360-241-0871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC1839101YM0800X
WALH00009398101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health