Provider Demographics
NPI:1548347297
Name:BARTHEL, CONSTANCE I (PA-C)
Entity type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:I
Last Name:BARTHEL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CONSTANCE
Other - Middle Name:
Other - Last Name:DUNN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2847
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97339-2847
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:531 N HIGHWAY 101 STE A
Practice Address - Street 2:
Practice Address - City:DEPOE BAY
Practice Address - State:OR
Practice Address - Zip Code:97341-9572
Practice Address - Country:US
Practice Address - Phone:541-765-3265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA60391373363A00000X, 363AM0700X
IA001644363AM0700X
ORPA204761363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical