Bryce Willardson, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

201404741 Issued in OR

Legal business name

BRYCE WILLARDSON, LLC

Practice address

83960 Spring Hill LN
Pleasant Hill, OR 97455-9728

Phone

(801) 824-4334

NPI assigned

Aug 4, 2018

Organization subpart

No

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

Authorized official

Name

Julie Willardson, FNP

Title

Owner

Phone

(801) 824-4334

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1533340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533340800000",
    "number": "1912485574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83960 SPRING HILL LN",
            "city": "PLEASANT HILL",
            "state": "OR",
            "postal_code": "974559728",
            "telephone_number": "801-824-4334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83960 SPRING HILL LN",
            "city": "PLEASANT HILL",
            "state": "OR",
            "postal_code": "974559728",
            "telephone_number": "801-824-4334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRYCE WILLARDSON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-04",
        "last_updated": "2018-08-04",
        "status": "A",
        "authorized_official_last_name": "WILLARDSON",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-824-4334",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "201404741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5006740",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Pleasant Hill, OR
• Providers in Pleasant Hill, 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 Aug 4, 2018; 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.