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Individual

KATHERINE HEATHER CAMP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
9555 SW BARNES RD STE 150, PORTLAND, OR 97225-6691
(503) 297-7403
Mailing address
1498 SE TECH CENTER PL STE 240, VANCOUVER, WA 98683-5508
(360) 597-1309

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA187487
OR
363AM0700X
Medical Physician Assistant
0010-02569
NC
363AM0700X
Medical Physician Assistant
5175
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0010-02569
LICENSE
NC
Enumeration date
11/09/2010
Last updated
04/20/2018
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