Provider Demographics
NPI:1760414262
Name:ENDO, JOYCE S (MD)
Entity Type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:S
Last Name:ENDO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:18380 WILLAMETTE DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-1200
Mailing Address - Country:US
Mailing Address - Phone:503-635-8384
Mailing Address - Fax:503-636-6475
Practice Address - Street 1:18380 WILLAMETTE DR
Practice Address - Street 2:SUITE 202
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-1200
Practice Address - Country:US
Practice Address - Phone:503-635-8384
Practice Address - Fax:503-636-6475
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORMD17097207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR001785001OtherBLUE CROSS
OR025556Medicaid
OR97068A003OtherCHAMPUS
OR001785001OtherBLUE CROSS
OR025556Medicaid