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NPI Code Detail

MEDICARE: BRYCE GILL

MEDICARE: BRYCE GILL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramOR

General Provider Information

NPI Number : 1700739125
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRYCE GILL
Provider Business Mailing Address
First Line : 5231 SE BYBEE BLVD
Second Line :
City : PORTLAND
State : OR
Zip : 97206-8212
Country : US
Telephone Number : 307-399-6009
Fax Number :
Provider Business Practice Location Address
First Line : 10260 SW GREENBURG RD STE 400
Second Line :
City : PORTLAND
State : OR
Zip : 97223-5514
Country : US
Telephone Number : 503-298-5096
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2026
Last Update Date : 02/16/2026

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Directions to “ BRYCE GILL ” Practice Location

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