Individual provider · Type 1 NPI

Bradley Paul Roan Eagle

Addiction (Substance Use Disorder) Counselor · Baker City, OR

NPI number 1497393425 Active

Practice location

3425 13th St
Baker City, OR 97814-1340

Specialties and licenses

TaxonomyCodeLicense
Case Manager/Care Coordinator 171M00000X20-QMHA-R-0842 (OR)
Peer Specialist 175T00000X21-CRM-411 (OR)
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XT-20-486 (OR)
Addiction (Substance Use Disorder) Counselor 101YA0400XCADC-RT-20-486 (OR)

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About NPI 1497393425

Bradley Paul Roan Eagle's National Provider Identifier is 1497393425, issued on Dec 20, 2019. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Baker City, OR. The record was last updated on Nov 17, 2025.