Provider Demographics
NPI:1528198090
Name:HUMPHREYS, JAMES C (CCP)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:C
Last Name:HUMPHREYS
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Gender:M
Credentials:CCP
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Mailing Address - Street 1:3600 NW SAMARITAN DR
Mailing Address - Street 2:SUITE 227
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-3737
Mailing Address - Country:US
Mailing Address - Phone:541-768-5223
Mailing Address - Fax:541-768-5014
Practice Address - Street 1:3600 NW SAMARITAN DR
Practice Address - Street 2:SUITE 227
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-3737
Practice Address - Country:US
Practice Address - Phone:541-768-5223
Practice Address - Fax:541-768-5014
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2013-03-18
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
940132OtherCLINICAL PERFUSIONIST