Individual
DR. BRYAN DEAN WALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2306 SE 39TH AVE, PORTLAND, OR 97214-5918
(503) 963-9181
(503) 963-9182
Mailing address
2306 SE 39TH AVE, PORTLAND, OR 97214-5918
(503) 963-9181
(503) 963-9182
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO20625
OR
Other
Enumeration date
06/14/2005
Last updated
09/18/2008
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