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Individual

ELYSIA CHURCHMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1140 SW SIMPSON AVE STE 110, BEND, OR 97702-3789
(541) 389-7741
(541) 278-8375
Mailing address
PO BOX 1517, PENDLETON, OR 97801-0410
(877) 708-1119
(541) 278-8349

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
175099
OR

Other

Enumeration date
01/28/2016
Last updated
12/30/2022
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