MR. JOHN PATRICK TULLY


Address: 17979 Ne Glisan St, Portland, OR 97230-6507
Phone: 8882273312

MR. JOHN PATRICK TULLY (NPI# 1992964563) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1992964563
Entity Type Individual
Full Name MR. JOHN PATRICK TULLY
Credential PA-C
Practice Address 17979 Ne Glisan St
Portland
OR 97230-6507
Mailing Address Po Box 3158
Portland
OR 97208-3158
Practice Telephone 8882273312
Enumeration Date 2008-06-08
Last Update Date 2016-11-16
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363A00000X Physician Assistant P175245 OR Physician Assistants & Advanced Practice Nursing Providers
N 363A00000X Physician Assistant 5008334-1206 UT Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
OR 500696906 05

Other Providers JOHN TULLY

NPI Name Taxonomy Address Enumeration
1265619993 John Owen Tully Internal Medicine 7580 Northcliff Ave Ste 1000, Brooklyn, OH 44144-3271 2008-01-24
1548468499 John M Tully Social Worker 13652 Cantara St, Panorama City, CA 91402-5423 2007-07-03
1356335772 John Tully Emergency Medicine 111 Dallas St, Emergency Room, San Antonio, TX 78205-1201 2005-08-31
1578565974 John Tully Internal Medicine 330 Mount Auburn St, South 2, Cambridge, MA 02138-5502 2005-08-15

Office Location

Street Address 17979 NE GLISAN ST
City PORTLAND
State OR
Zip Code 97230-6507

Providers in the same location

NPI Name Taxonomy Address Enumeration
1326053307 Walgreen Co Pharmacy 17979 Ne Glisan St, Portland, OR 97230-6507 2006-07-29
1790212983 Megan Kaye Jasper Physician Assistant 17979 Ne Glisan St, Portland, OR 97230 2017-05-18
1255887642 Laura Nicole Rogers Physician Assistant 17979 Ne Glisan St, Portland, OR 97230-6507 2016-08-26
1013329002 Olubanke Babalola Nurse Practitioner 17979 Ne Glisan St, Portland, OR 97230-6507 2014-05-23
1548685480 Jigisha Mehta Pharmacist 17979 Ne Glisan St, Portland, OR 97230 2014-03-01
1649574443 Miranda Shea Boeh Nurse Practitioner 17979 Ne Glisan St, Portland, OR 97230-6507 2011-01-07
1730412974 Val M Devogele Pharmacist 17979 Ne Glisan St, Portland, OR 97230 2009-09-04

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1932687233 Timisha K Wilson Social Worker 12505 Ne Halsey St, Portland, OR 97230 2018-07-30
1356828768 Sally Gail Logan Pharmacist 5725 Ne 138th Avenue, Portland, OR 97230 2018-07-27
1063937951 Marley Elizabeth Small Counselor 1507 Ne 122nd Ave., Portland, OR 97230 2017-08-11
1447771316 Shadab Nasreen Aijazi Pathology 5220 Ne 122nd Avenue, Portland, OR 97230 2017-06-30
1104378199 Derek Andrus Pharmacist 5717 Nw 138th, Portland, OR 97230 2016-10-26
1164972675 Rachael Anderson Adult Companion 423 Ne 160th Ave #11, Portland, OR 97230 2016-10-07
1750837597 Providence Elderplace Assisted Living Facility 16430 Ne Hoyt St, Portland, OR 97230 2016-08-31
1649622473 Sara Mcgroarty Counselor 17710 Ne Halsey Street, Portland, OR 97230 2016-07-05
1346699949 Steven D Stanton Counselor 1022 Ne 181st Ave, C1, Portland, OR 97230 2016-06-06
1215390091 The Wallace Medical Concern Clinic/Center 18139 Ne Couch Street, Portland, OR 97230 2016-03-30
Find all providers in zip 97230

Taxonomy Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1427676493 Lindsey Louise Peterson Physician Assistant 3505 N Williams Ave, Portland, OR 97227-1437 2020-07-07
1518584036 Abigail Nichole Dumont Physician Assistant 6064 Sw 30th Ave, Portland, OR 97239-1018 2020-06-30
1336769637 Molly Tanguay Physician Assistant 23 Bramhall St, Portland, ME 04102-3121 2020-04-16
1063040525 Jessica Nursick Physician Assistant 26 Sand Hill Rd, Portland, CT 06480-1737 2020-03-31
1689217630 Evan Eisher Physician Assistant 3809 Se Stephens St, Portland, OR 97214-5248 2019-10-22
1508407941 Amie Bates Physician Assistant 1040 Nw 22nd Ave # Ll030, Portland, OR 97210-3057 2019-10-07
1558923326 Mackenzie Graye Mcmillin Physician Assistant 1601 Congress St Ste 1, Portland, ME 04102-2145 2019-07-02
1447812268 Maksim Yefimov Physician Assistant 2800 N Vancouver Ave Ste 130, Portland, OR 97227 2019-07-01
1942794839 Michael Peterson Physician Assistant 3181 Sw Sam Jackson Park Rd # P31, Portland, OR 97239-3098 2018-06-14
1306383930 Rachel Lynn Witowski Physician Assistant 2124 Nw Hoyt St, Portland, OR 97210-3215 2017-01-20
Find all providers in PORTLAND

Competitor

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City PORTLAND
Zip Code 97230

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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