Bryan D. Walls, D.O. P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO20625 Issued in OR

Legal business name

BRYAN D. WALLS, D.O. P.C.

Doing business as

Hawthorne Family Medicine

Practice address

2306 SE 39TH Ave
Portland, OR 97214-5918

Phone

(503) 963-9181

Fax

(503) 963-9182

NPI assigned

Sep 18, 2008

Last updated

Sep 18, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Bryan Dean Walls, D.O.NPI 1710982129

Title

Physician

Phone

(503) 963-9181

Specialties & licenses 1

Addresses

Other names 1

• Hawthorne Family Medicine Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bryan Dean Walls, D.O.

  • Family Medicine Physician
  • Portland, OR
  • NPI 1710982129
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1221696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221696000000",
    "number": "1467601096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2306 SE 39TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972145918",
            "telephone_number": "503-963-9181",
            "fax_number": "503-963-9182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2306 SE 39TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972145918",
            "telephone_number": "503-963-9181",
            "fax_number": "503-963-9182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRYAN D. WALLS, D.O. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-18",
        "last_updated": "2008-09-18",
        "status": "A",
        "authorized_official_last_name": "WALLS",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "503-963-9181",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO20625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hawthorne Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Reginald D. Bruss, MD
• Stephen James Brusse, DMD
• Elizabeth R Bruton, PNP
• Bryan Baisinger, PC (Clearwater Clinic)
• Bryan Bingham D.C. P.C. (Highland Chiropractic Clinic)
• Andrew J Bryan, MD
• Bradley T Bryan, M.D.
• Emily Bryan
• James Edward Bryan, PH.D.
• James H. Bryan, MD, PHD

• Family Medicine Physician in Portland, OR
• Providers in Portland, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.