Provider Demographics
NPI:1225019458
Name:PASTORE, PAMELA BETTY (NP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:BETTY
Last Name:PASTORE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 N COLUMBIA RIVER HWY
Mailing Address - Street 2:
Mailing Address - City:SAINT HELENS
Mailing Address - State:OR
Mailing Address - Zip Code:97051-1299
Mailing Address - Country:US
Mailing Address - Phone:503-397-0471
Mailing Address - Fax:
Practice Address - Street 1:500 N COLUMBIA RIVER HWY
Practice Address - Street 2:
Practice Address - City:SAINT HELENS
Practice Address - State:OR
Practice Address - Zip Code:97051-1299
Practice Address - Country:US
Practice Address - Phone:503-397-0471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-05
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201350067NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO68270348Medicaid
COP00116704OtherRR MEDICARE
COC806574Medicare PIN