Individual
JOHANE VAN CAMP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18819 PEONY PL, BEND, OR 97702-9135
(541) 408-2721
Mailing address
18819 PEONY PL, BEND, OR 97702-9135
(541) 408-2721
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
OR
363AM0700X
Medical Physician Assistant
PA00517
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA00517
OREGON MEDICAL BOARD
OR
Enumeration date
06/11/2018
Last updated
06/16/2018
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