Provider Demographics
NPI:1336102839
Name:ZOELLER, PAMELA ANNE (ARNP)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:ANNE
Last Name:ZOELLER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:ZOELLER
Other - Last Name:HOWARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN MSN CS
Mailing Address - Street 1:PO BOX 3428
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383
Mailing Address - Country:US
Mailing Address - Phone:360-698-4860
Mailing Address - Fax:360-698-3849
Practice Address - Street 1:9201 SILVERDALE WAY NW
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383
Practice Address - Country:US
Practice Address - Phone:360-698-4860
Practice Address - Fax:360-698-3849
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30004162363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB32026Medicare ID - Type Unspecified