Provider Demographics
NPI:1336808401
Name:HAMILTON, CAMERON HAROLD (ATC)
Entity Type:Individual
Prefix:
First Name:CAMERON
Middle Name:HAROLD
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14897 SE PARKLANE DR
Mailing Address - Street 2:
Mailing Address - City:HAPPY VALLEY
Mailing Address - State:OR
Mailing Address - Zip Code:97015-5518
Mailing Address - Country:US
Mailing Address - Phone:503-353-5750
Mailing Address - Fax:
Practice Address - Street 1:14897 SE PARKLANE DR
Practice Address - Street 2:
Practice Address - City:HAPPY VALLEY
Practice Address - State:OR
Practice Address - Zip Code:97015-5518
Practice Address - Country:US
Practice Address - Phone:503-353-5750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-15
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAT-AT-101737992255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer