Healthcare Provider Details

I. General information

NPI: 1295420446
Provider Name (Legal Business Name): CAMAS PERIODONTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2023
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3517 NW CAMAS MEADOWS DR STE 200
CAMAS WA
98607-6602
US

IV. Provider business mailing address

3517 NW CAMAS MEADOWS DR
CAMAS WA
98607-6601
US

V. Phone/Fax

Practice location:
  • Phone: 360-818-2232
  • Fax: 360-818-2261
Mailing address:
  • Phone: 360-818-2232
  • Fax: 360-818-2261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. DUY ANH TRAN
Title or Position: OWNER/PERIODONTIST
Credential: DMD
Phone: 503-380-5872