Provider Demographics
NPI:1043654742
Name:HONGEL, PAMELA CHRISTINE (CDPT)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:CHRISTINE
Last Name:HONGEL
Suffix:
Gender:F
Credentials:CDPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 NW 20TH AVE
Mailing Address - Street 2:
Mailing Address - City:BATTLE GROUND
Mailing Address - State:WA
Mailing Address - Zip Code:98604-4534
Mailing Address - Country:US
Mailing Address - Phone:360-600-3831
Mailing Address - Fax:
Practice Address - Street 1:801 NW 20TH AVE
Practice Address - Street 2:
Practice Address - City:BATTLE GROUND
Practice Address - State:WA
Practice Address - Zip Code:98604-4534
Practice Address - Country:US
Practice Address - Phone:360-600-3831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-24
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACO 60169242101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO60169242OtherCHEMICAL DEPENDENCY COUNSELOR