| Doctor Name: | LESLIE K BAGON |
| NPI Number: | 1245298280 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 2799 |
| Business Practice Address: | 51579 Columbia River Hwy Ste 'i' Scappoose, OR - 970568411 |
| Business Phone Number: | 5035436164 |
| Business Fax Number: | 5035436040 |
| Mailing Address: | 18100 Sauvie Island Rd, PORTLAND |
| State: | OR |
| Postal Code: | 972311311 |
| Phone Number: | 5032481738 |
| Fax Number: | |
| NPI Enumeration Date: | 05/01/2006 |
| NPI Last Update Date: | 10/03/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 2799 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |