Organization
BRYCE WILLARDSON, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE WILLARDSON FNP (OWNER)
(801) 824-4334
Entity
Organization
Contact information
Practice address
83960 SPRING HILL LN, PLEASANT HILL, OR 97455-9728
(801) 824-4334
Mailing address
83960 SPRING HILL LN, PLEASANT HILL, OR 97455-9728
(801) 824-4334
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
201404741
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5006740
—
OR
Enumeration date
08/04/2018
Last updated
08/04/2018
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