BRYHANNA CHRISTINE CHARLES PAC NPI 1154919561

NPI Information

NPI: 1154919561
Provider Name: BRYHANNA CHRISTINE CHARLES, PAC
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

PECOS Registration: Yes

Address:
1111 NE 99TH AVE STE 101
PORTLAND, OR
ZIP 97220
Phone: (503) 488-2626
Get Directions

Bryhanna Christine Charles, PAC is a surgical physician assistant in Portland, OR with 3 years of experience. Bryhanna Christine Charles, PAC NPI is 1154919561. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1111 NE 99TH AVE STE 101
PORTLAND, OR
ZIP 97220-442
Phone: (503) 488-2626
Fax: (503) 488-2630

The NPI 1154919561 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/2/2021 and was last updated on 7/11/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363A00000X	Physician Assistant		085008846	ILLINOIS	No
2	363AS0400X	Physician Assistant	Surgical	PA209821	OREGON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	2209836	MEDICAID	WASHINGTON
2	500807348	MEDICAID	OR

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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