# LACAMAS MEDICAL GROUP PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649280462
- **Authorized official:** SCOTT JONASON (PRESIDENT)
- **Authorized official phone:** (360) 838-2440

## Contact information

- **Practice address:** 3240 NE 3RD AVE, CAMAS, WA 98607-2408
- **Practice address phone:** (360) 838-2440
- **Mailing address:** 3240 NE 3RD AVE, CAMAS, WA 98607-2408
- **Mailing address phone:** (360) 838-2440
- **Mailing address fax:** (360) 838-2450

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | PA10003185 | WA | Yes |

## Other

- **Enumeration date:** 08/08/2006
- **Last updated:** 04/21/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7117096 | — | WA |