Provider Demographics
NPI:1053648410
Name:BAUMGARTNER, PAMELA CHRISTINE (OROFACIAL MYOLOGIST)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:CHRISTINE
Last Name:BAUMGARTNER
Suffix:
Gender:F
Credentials:OROFACIAL MYOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1224 N MURRAY LN
Mailing Address - Street 2:
Mailing Address - City:LIBERTY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99019-7555
Mailing Address - Country:US
Mailing Address - Phone:509-998-5122
Mailing Address - Fax:509-892-7996
Practice Address - Street 1:1224 N MURRAY LN
Practice Address - Street 2:
Practice Address - City:LIBERTY LAKE
Practice Address - State:WA
Practice Address - Zip Code:99019-7555
Practice Address - Country:US
Practice Address - Phone:509-998-5122
Practice Address - Fax:509-892-7996
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-05
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other