Individual
CAMERON J WYCHANKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
9292 W BARNES DR, BOISE, ID 83709-1554
(208) 795-3515
Mailing address
1650 S TOPAZ WAY, MERIDIAN, ID 83642-4474
(208) 605-7070
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-2439
ID
Other
Enumeration date
07/05/2022
Last updated
02/21/2023
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