Provider Demographics
NPI:1396072856
Name:DUNN, CAMRON CHALMERS (LMT)
Entity type:Individual
Prefix:MR
First Name:CAMRON
Middle Name:CHALMERS
Last Name:DUNN
Suffix:
Gender:M
Credentials:LMT
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 426
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-0426
Mailing Address - Country:US
Mailing Address - Phone:503-434-1738
Mailing Address - Fax:
Practice Address - Street 1:1709 NE 27TH ST STE J
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-2347
Practice Address - Country:US
Practice Address - Phone:503-434-1738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-04
Last Update Date:2018-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR16243225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR16243OtherOREGON BOARD OF MASSAGE THERAPISTS