Provider Demographics
NPI:1538240916
Name:CAMP, RONALD D (MA/QMHP)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:D
Last Name:CAMP
Suffix:
Gender:M
Credentials:MA/QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 N. HWY.99 W
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128
Mailing Address - Country:US
Mailing Address - Phone:503-472-4020
Mailing Address - Fax:503-472-8630
Practice Address - Street 1:819 N HWY. 99 W
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128
Practice Address - Country:US
Practice Address - Phone:503-472-4020
Practice Address - Fax:503-472-8630
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health