Provider Demographics
NPI:1215707591
Name:LONG, EMILY CLAIRE (PA)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:CLAIRE
Last Name:LONG
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:64545 RESEARCH RD
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-8583
Mailing Address - Country:US
Mailing Address - Phone:541-848-7822
Mailing Address - Fax:
Practice Address - Street 1:64545 RESEARCH RD
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-8583
Practice Address - Country:US
Practice Address - Phone:541-848-7822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant