Cameron J Wychanko, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA-2439 Issued in ID

Practice address

9292 W Barnes Dr
Boise, ID 83709-1554

Phone

(208) 795-3515

NPI assigned

Jul 5, 2022

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ashwood Recovery LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Boise, ID
  • NPI 1043545106
  NPD (past)
• Ashwood Recovery LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Boise, ID
  • NPI 1801452677
  NPD (past)
• Northpoint Recovery LLC

  • Substance Abuse Rehabilitation Facility
  • Meridian, ID
  • NPI 1154709087
  NPD (past)
• Evergreen at Northpoint LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Seattle, WA
  • NPI 1942735667
  NPD (past)
• Northpoint Washington LLC

  • Substance Abuse Rehabilitation Facility
  • Edmonds, WA
  • NPI 1891292900
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1656979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676937600000",
    "number": "1659004869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 S TOPAZ WAY",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836424474",
            "telephone_number": "208-605-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9292 W BARNES DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837091554",
            "telephone_number": "208-795-3515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2335 E State Ave",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "836428808",
            "country_code": "US",
            "telephone_number": "208-672-1801",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6600 W Emerald St",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837048738",
            "country_code": "US",
            "telephone_number": "208-609-9020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "847 Parkcentre Way Ste 7",
            "address_purpose": "LOCATION",
            "city": "Nampa",
            "state": "ID",
            "postal_code": "836511794",
            "country_code": "US",
            "telephone_number": "208-229-6050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7941 W Rifleman St",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837049001",
            "country_code": "US",
            "telephone_number": "208-895-7950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYCHANKO",
        "first_name": "CAMERON",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-05",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-2439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Wussow, RN
• Gentry David Wuthrich
• Kelly Iva Wuthrich, RN, BSN
• Casi McPherson Wyatt, DO
• Christopher C Wyatt, MD
• Stephanie Wyler, PA-S
• Steven Wyman, MD
• Donraphael Wynn, M.D.
• Elizabeth Mary Wynn
• Amy Wysong, DO

• Physician Assistant in Boise, ID
• Providers in Boise, ID by specialty
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.