Provider Demographics
NPI:1710406012
Name:PINCOCK, CAMILLE ELLEN (PA-C)
Entity type:Individual
Prefix:MS
First Name:CAMILLE
Middle Name:ELLEN
Last Name:PINCOCK
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 E 10TH AVE STE 308
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3687
Mailing Address - Country:US
Mailing Address - Phone:541-500-2500
Mailing Address - Fax:971-261-1705
Practice Address - Street 1:360 E 10TH AVE STE 308
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3273
Practice Address - Country:US
Practice Address - Phone:208-720-3948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-18
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR184785363A00000X
ORPA1847852084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant