Provider Demographics
NPI:1649776949
Name:CAMACHO, JUAN RAMON (DC)
Entity Type:Individual
Prefix:
First Name:JUAN
Middle Name:RAMON
Last Name:CAMACHO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 DOUGLAS ST
Mailing Address - Street 2:
Mailing Address - City:GRANDVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98930-1334
Mailing Address - Country:US
Mailing Address - Phone:509-305-5163
Mailing Address - Fax:
Practice Address - Street 1:403 N EUCLID ST
Practice Address - Street 2:
Practice Address - City:GRANDVIEW
Practice Address - State:WA
Practice Address - Zip Code:98930-9407
Practice Address - Country:US
Practice Address - Phone:509-402-9020
Practice Address - Fax:509-402-9036
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60841231111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner