Provider Demographics
NPI:1326364274
Name:COLBY, PAMELA ALLANE (ND)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:ALLANE
Last Name:COLBY
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 S FAIRMONT AVE STE B
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:CA
Mailing Address - Zip Code:95240-4643
Mailing Address - Country:US
Mailing Address - Phone:800-738-7303
Mailing Address - Fax:800-738-7303
Practice Address - Street 1:755 S FAIRMONT AVE STE B
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95240-4643
Practice Address - Country:US
Practice Address - Phone:800-738-7303
Practice Address - Fax:800-738-7303
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-18
Last Update Date:2010-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND-392175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath