Individual
MR. JOHN PATRICK TULLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
61250 SE COOMBS PL, BEND, OR 97702-3704
(541) 706-5930
(541) 706-5931
Mailing address
PO BOX 6048, BEND, OR 97708-6048
(541) 382-4900
(541) 706-2398
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5008334-1206
UT
363A00000X
Physician Assistant
Primary
P175245
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500696906
—
OR
Enumeration date
06/08/2008
Last updated
05/01/2026
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