Provider Demographics
NPI:1760454615
Name:CAMARA, JOCELYN F (MD)
Entity Type:Individual
Prefix:DR
First Name:JOCELYN
Middle Name:F
Last Name:CAMARA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3777
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-3777
Mailing Address - Country:US
Mailing Address - Phone:503-413-3900
Mailing Address - Fax:503-413-3710
Practice Address - Street 1:1960 NW 167TH PL., SUITE 205
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006
Practice Address - Country:US
Practice Address - Phone:503-413-7162
Practice Address - Fax:503-672-6131
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD417346174400000X
OR150847207RC0000X
ORMD150847207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500627212Medicaid
PA001881876Medicaid
PAH56507Medicare UPIN
PA001881876Medicaid
OR500627212Medicaid