MEDICARE: MS. CAMILLE ELLEN PINCOCK PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	184785	OR
2	2084P0800X	Psychiatry Physician	PA184785	OR

General Provider Information

NPI Number	:	1710406012
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CAMILLE ELLEN PINCOCK PA-C

Provider Business Mailing Address
First Line	:	360 E 10TH AVE STE 308
Second Line	:
City	:	EUGENE
State	:	OR
Zip	:	97401-3687
Country	:	US
Telephone Number	:	541-500-2500
Fax Number	:	971-261-1705

Provider Business Practice Location Address
First Line	:	360 E 10TH AVE STE 308
Second Line	:
City	:	EUGENE
State	:	OR
Zip	:	97401-3273
Country	:	US
Telephone Number	:	208-720-3948
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/18/2017
Last Update Date	:	04/24/2025

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