Provider Demographics
NPI:1215903315
Name:BELNAP, CAMERON J (DC)
Entity type:Individual
Prefix:DR
First Name:CAMERON
Middle Name:J
Last Name:BELNAP
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 A STREET WEST
Mailing Address - Street 2:
Mailing Address - City:VALE
Mailing Address - State:OR
Mailing Address - Zip Code:97918-1303
Mailing Address - Country:US
Mailing Address - Phone:541-473-9000
Mailing Address - Fax:208-466-0547
Practice Address - Street 1:723 16TH AVE S
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83651-4729
Practice Address - Country:US
Practice Address - Phone:208-466-1600
Practice Address - Fax:208-466-0547
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-27
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA-1110111N00000X
OR3575111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDV04474Medicare UPIN
ID1675686Medicare ID - Type Unspecified
ORR136795Medicare PIN