Provider Demographics
NPI:1366659922
Name:WRIGHT, PAMELA DYAN (CPM)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:DYAN
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:E
Other - Last Name:BREAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LM
Mailing Address - Street 1:326 3RD AVE W
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59912-4001
Mailing Address - Country:US
Mailing Address - Phone:406-892-5530
Mailing Address - Fax:
Practice Address - Street 1:2640 HWY 2 EAST
Practice Address - Street 2:SUITE A
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901
Practice Address - Country:US
Practice Address - Phone:406-892-5530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT26176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife