| Brant William Ullery, MD | |
|
25030 Sw Parkway Ave Ste 200, Wilsonville, OR 97070-9816 | |
| (971) 434-0080 | |
| (503) 946-3891 |
| Full Name | Brant William Ullery |
|---|---|
| Gender | Male |
| Speciality | General Surgery |
| Experience | 17 Years |
| Location | 25030 Sw Parkway Ave Ste 200, Wilsonville, Oregon |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588826804 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2086S0129X | Surgery - Vascular Surgery | MD171554 (Oregon) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Providence Portland Medical Center | Portland, OR | Hospital |
| Providence St Vincent Medical Center | Portland, OR | Hospital |
| Providence Newberg Medical Center | Newberg, OR | Hospital |
| Adventist Health Tillamook | Tillamook, OR | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Oregon Vascular Specialists Llc | 8022386663 | 11 |
| Entity Name | Providence Health & Services - Oregon |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003991845 PECOS PAC ID: 5395656284 Enrollment ID: O20031113000626 |
| Entity Name | Oregon Vascular Specialists Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1669917167 PECOS PAC ID: 8022386663 Enrollment ID: O20170622001858 |
| Mailing Address | Practice Location Address |
|---|---|
| Brant William Ullery, MD 25030 Sw Parkway Ave Ste 200, Wilsonville, OR 97070-9816 Ph: (971) 434-0080 | Brant William Ullery, MD 25030 Sw Parkway Ave Ste 200, Wilsonville, OR 97070-9816 Ph: (971) 434-0080 |
Dr. Richard Brad Cook, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 25030 Sw Parkway Ave Ste 200, Wilsonville, OR 97070 Phone: 971-434-0080 Fax: 503-946-3891 | |
Vincent Joseph Santo Iii, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 25030 Sw Parkway Ave Ste 200, Wilsonville, OR 97070 Phone: 971-434-0080 Fax: 503-946-3891 | |
John Noel Dussel, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 25030 Sw Parkway Ave Ste 200, Wilsonville, OR 97070 Phone: 971-434-0080 Fax: 503-946-3891 |