Provider Demographics
NPI:1871047431
Name:CHRISTY, BRANDON RYAN (DC)
Entity type:Individual
Prefix:MR
First Name:BRANDON
Middle Name:RYAN
Last Name:CHRISTY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1488 SE 52ND AVE
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-7644
Mailing Address - Country:US
Mailing Address - Phone:541-410-6776
Mailing Address - Fax:
Practice Address - Street 1:12923 NW CORNELL RD STE 201
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97229-5834
Practice Address - Country:US
Practice Address - Phone:503-646-3393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-11
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002998A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor