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MR. BRADLEY PAUL ROAN EAGLE
NPI 1497393425
Counselor - Addiction (Substance Use Disorder) in Baker City, OR

Active since December 20, 2019
3425 13TH ST, BAKER CITY, OR 97814(605) 516-0083 Get Directions Write a Review

NPPES record last updated: November 17, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 17, 2025, Apr 8, 2021, Mar 19, 2021 and 2 more (5 updates tracked since 2019).

About Mr. Bradley Paul Roan Eagle NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. BRADLEY PAUL ROAN EAGLE (NPI 1497393425) is an individual addiction (substance use disorder) provider in Baker City, Oregon, licensed in Oregon (T-20-486) and active in the NPI registry since December 2019.

NPPES Registry Identity

NPI1497393425
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameMR. BRADLEY PAUL ROAN EAGLE
Location Address3425 13TH STBaker City, OR 97814-1340
Mailing Address3425 13th StBaker City, OR 97814-1340 · (541) 523-7400 · Fax (541) 523-4927
Phone(605) 516-0083
Sole ProprietorNo
Enumeration DateDecember 20, 2019
Last NPPES UpdateNovember 17, 20255 updates tracked since enumeration
NPPES CertifiedNovember 17, 2025
✔ NPI 1497393425 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
Licenses✔ Licensed in OR · T-20-486✔ Licensed in OR · CADC-RT-20-486
Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X · License 20-QMHA-R-0842 (OR)
Also ListedPeer SpecialistTaxonomy 175T00000X · License 21-CRM-411 (OR)
3425 13TH ST, Baker City, OR 97814
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Other Identifiers 2

Other21-CRM-411OR · Crm Certificate - Mhacbo
Medicaid50079031OR

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

COLLEEN BETTILYEN DAVENPORT PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
3425 13TH ST
BAKER CITY, OR 97814
Baker County (541) 523-7400
DIANE EILEEN WROE
Case Manager/Care Coordinator
3425 13TH ST
BAKER CITY, OR 97814
Baker County (541) 523-7400
KATIE ELIZABETH LEAL
Counselor (Addiction (Substance Use Disorder))
3425 13TH ST
BAKER CITY, OR 97814
Baker County (541) 523-7400
COURTNEY ANN HAYS
Case Manager/Care Coordinator
3425 13TH ST
BAKER CITY, OR 97814
Baker County (541) 523-7400
PETER SKYE FARNAM
Counselor (Mental Health)
3425 13TH ST
BAKER CITY, OR 97814
Baker County (541) 523-7400
MS. KIMBERLY ANN HAM
Counselor (Addiction (Substance Use Disorder))
3425 13TH ST
BAKER CITY, OR 97814
Baker County (541) 523-7400
CAROL LEE YOUNG
Case Manager/Care Coordinator
3425 13TH ST
BAKER CITY, OR 97814
Baker County (541) 523-7400
CHARLES JUDSON KEYS
Case Manager/Care Coordinator
3425 13TH ST
BAKER CITY, OR 97814
Baker County (541) 523-7400

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bradley Roan Eagle's NPI number?

The NPI number for Bradley Roan Eagle is 1497393425. It was assigned to this individual provider in the NPPES registry on December 20, 2019.

Where is Bradley Roan Eagle located?

Bradley Roan Eagle practices at 3425 13th St, Baker City, OR 97814. The listed phone number is (605) 516-0083.

What is Bradley Roan Eagle's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Bradley Roan Eagle was last updated on November 17, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.