Provider Demographics
NPI:1891987079
Name:CAMELI, CHRISTINA JANETTE
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:JANETTE
Last Name:CAMELI
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 1:5935 SE BELMONT ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97215-1925
Mailing Address - Country:US
Mailing Address - Phone:971-328-0083
Mailing Address - Fax:833-390-1391
Practice Address - Street 1:5935 SE BELMONT ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97215-1925
Practice Address - Country:US
Practice Address - Phone:971-328-0083
Practice Address - Fax:833-390-1391
Is Sole Proprietor?:No
Enumeration Date:2007-08-13
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200750112NP367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR274540Medicaid
ORR172974OtherMEDICARE PTAN