Individual
BRYHANNA CHRISTINECHARLES MCCULLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1111 NE 99TH AVE STE 101, PORTLAND, OR 97220-9442
(503) 488-2626
(503) 488-2630
Mailing address
847 NE 19TH AVE STE 300, PORTLAND, OR 97232-2686
(503) 963-2801
(503) 963-2825
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085008846
IL
363AS0400X
Surgical Physician Assistant
Primary
PA209821
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2209836
—
WA
05
—
500807348
—
OR
Enumeration date
01/02/2021
Last updated
03/02/2026
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