Provider Demographics
NPI:1356704159
Name:BRYSON, ASHLEY (MD)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
Last Name:BRYSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 163
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477-0024
Mailing Address - Country:US
Mailing Address - Phone:541-735-9420
Mailing Address - Fax:541-747-9870
Practice Address - Street 1:1435 G ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-4113
Practice Address - Country:US
Practice Address - Phone:541-735-9420
Practice Address - Fax:541-747-9870
Is Sole Proprietor?:No
Enumeration Date:2016-03-30
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD187608207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine