{"npi":"1154919561","type":"NPI-1","status":"active","name":{"display":"Bryhanna Mccully Pac","other":[],"first":"BRYHANNA","last":"MCCULLY","middle":"CHRISTINECHARLES","credential":"PAC"},"specialty":{"primary_taxonomy":"363A00000X","primary_taxonomy_description":"Physician Assistant","slug":"physician-assistant","schema_org_specialty":null,"all":[{"code":"363AS0400X","description":"Surgical Physician Assistant","primary":false,"state":"OR","license":"PA209821"},{"code":"363A00000X","description":"Physician Assistant","primary":true,"state":"OR","license":"PA209821"},{"code":"363A00000X","description":"Physician Assistant","primary":false,"state":"IL","license":"085008846"}]},"addresses":[{"purpose":"LOCATION","street_1":"2850 SE POWELL VALLEY RD","city":"GRESHAM","state":"OR","postal_code":"970801494","country_code":"US","phone":"5036665050"},{"purpose":"MAILING","street_1":"PO BOX 3777","city":"PORTLAND","state":"OR","postal_code":"972083777","country_code":"US","phone":"5034133900","fax":"5034133710"}],"license":{"state":"OR","number":"PA209821"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"500807348","state":"OR","issuer":null},{"type_code":"05","label":"Medicaid","value":"2209836","state":"WA","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20220707003268","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"OR","pac_id":"4385037332"}]},"enumeration_date":"2021-01-02","last_updated":"2026-06-17","_meta":{"source":"NPPES","snapshot_date":"2026-06-17","doc_url":"https://findmynpi.com/api"}}