Individual
DR. BRYSON GRANT HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7500
(503) 494-4997
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7500
(503) 494-4997
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD183171
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD183171
OREGON MEDICAL BOARD
OR
Enumeration date
05/27/2014
Last updated
03/07/2023
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