Provider Demographics
NPI:1083837983
Name:RAGLE, PAMELA DEE (MS,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:DEE
Last Name:RAGLE
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2909 S IRBY CT
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99337-2461
Mailing Address - Country:US
Mailing Address - Phone:509-734-2575
Mailing Address - Fax:
Practice Address - Street 1:552 N COLORADO ST STE 210
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-7781
Practice Address - Country:US
Practice Address - Phone:509-734-2575
Practice Address - Fax:186-654-6859
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00002634235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7102270Medicaid
WALL00002634Medicare UPIN