Provider Demographics
NPI:1932212883
Name:BOURKE, JOSEPHINE BILBAO (LCSW)
Entity Type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:BILBAO
Last Name:BOURKE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JOSIE
Other - Middle Name:IRUNE
Other - Last Name:BILBAO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:555 SE MLK JR BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-2120
Mailing Address - Country:US
Mailing Address - Phone:541-313-6509
Mailing Address - Fax:
Practice Address - Street 1:555 SE MLK JR BLVD STE 105
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-2120
Practice Address - Country:US
Practice Address - Phone:541-313-6509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL3407101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health