Provider Demographics
NPI:1518962166
Name:CAMP, PERRY E (MD)
Entity Type:Individual
Prefix:DR
First Name:PERRY
Middle Name:E
Last Name:CAMP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 1663
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-0031
Mailing Address - Country:US
Mailing Address - Phone:509-529-1284
Mailing Address - Fax:509-522-1798
Practice Address - Street 1:301 W POPLAR ST
Practice Address - Street 2:STE 220
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-2858
Practice Address - Country:US
Practice Address - Phone:509-522-1030
Practice Address - Fax:509-529-6066
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00015038207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR239392Medicaid
WA8877672OtherGROUP MDCR PIN
WA140000043OtherRAILROAD MEDICARE
WACA5312OtherREGENCE WA SATE
WAA09368Medicare UPIN
WACA5312OtherREGENCE WA SATE