Provider Demographics
NPI:1790537157
Name:BRYANT, ALESSIA (PA-C)
Entity type:Individual
Prefix:
First Name:ALESSIA
Middle Name:
Last Name:BRYANT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:840 ROYAL AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-6461
Mailing Address - Country:US
Mailing Address - Phone:541-732-8370
Mailing Address - Fax:
Practice Address - Street 1:13001 E 17TH PL RM E7019
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2570
Practice Address - Country:US
Practice Address - Phone:303-794-7963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-01
Last Update Date:2024-10-18
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant