Provider Demographics
NPI:1467562280
Name:POLLOCK, PAMELA A (MBA, MA)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:A
Last Name:POLLOCK
Suffix:
Gender:F
Credentials:MBA, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2611 NE 125TH STREET, SUITE 104
Mailing Address - Street 2:LAKE CITY PROFESSIONAL CENTER
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125
Mailing Address - Country:US
Mailing Address - Phone:206-299-2229
Mailing Address - Fax:206-299-0008
Practice Address - Street 1:2611 NE 125TH ST
Practice Address - Street 2:SUITE 104
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-4373
Practice Address - Country:US
Practice Address - Phone:206-299-2229
Practice Address - Fax:206-299-0008
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60158757101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health