Provider Demographics
NPI:1558784413
Name:EIMAN, JOANN
Entity Type:Individual
Prefix:
First Name:JOANN
Middle Name:
Last Name:EIMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2218 SHALLOCK AVE
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97601-4290
Mailing Address - Country:US
Mailing Address - Phone:541-882-3818
Mailing Address - Fax:541-882-9800
Practice Address - Street 1:2821 DAGGETT AVE STE 200
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97601-1106
Practice Address - Country:US
Practice Address - Phone:541-274-8400
Practice Address - Fax:541-274-8405
Is Sole Proprietor?:No
Enumeration Date:2014-01-29
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant