Basic Information
| Provider Information | |||||||||
| NPI: | 1558784413 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | EIMAN | ||||||||
| FirstName: | JOANN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2218 SHALLOCK AVE | ||||||||
| Address2: | |||||||||
| City: | KLAMATH FALLS | ||||||||
| State: | OR | ||||||||
| PostalCode: | 976014290 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5418823818 | ||||||||
| FaxNumber: | 5418829800 | ||||||||
| Practice Location | |||||||||
| Address1: | 2821 DAGGETT AVE STE 200 | ||||||||
| Address2: | |||||||||
| City: | KLAMATH FALLS | ||||||||
| State: | OR | ||||||||
| PostalCode: | 976011106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5412748400 | ||||||||
| FaxNumber: | 5412748405 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/29/2014 | ||||||||
| LastUpdateDate: | 07/18/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.