Individual
DR. DOMINIQUE CAMILLE FONTENETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
351 SW 9TH ST, ONTARIO, OR 97914-2639
(541) 881-7000
Mailing address
311 30TH AVE, SEATTLE, WA 98122-6223
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
243657
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110086500A
—
MA
01
—
AA186492
HARVARD PILGRIM
MA
Enumeration date
07/05/2007
Last updated
12/10/2014
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