Provider Demographics
NPI:1427009919
Name:TURNER, PAMELA E (MD)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:E
Last Name:TURNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3158
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-3158
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16770 SW EDY RD
Practice Address - Street 2:SUITE 102
Practice Address - City:SHERWOOD
Practice Address - State:OR
Practice Address - Zip Code:97140-9678
Practice Address - Country:US
Practice Address - Phone:503-215-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD14397207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR130104Medicaid
110162962OtherMEDICARE RAILROAD
OR130104Medicaid
ORR144531Medicare PIN
110162962OtherMEDICARE RAILROAD
ORR153220Medicare PIN
ORR154926Medicare PIN
ORR144529Medicare PIN
D86805Medicare UPIN
ORR144534Medicare PIN
ORR144533Medicare PIN