Provider Demographics
NPI:1467633263
Name:COLLINS, PAMELA JEAN (MHE)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:JEAN
Last Name:COLLINS
Suffix:
Gender:F
Credentials:MHE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4301 S PINE ST STE 32
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98409-7252
Mailing Address - Country:US
Mailing Address - Phone:253-697-8620
Mailing Address - Fax:253-697-8630
Practice Address - Street 1:4301 S PINE ST STE 32
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409-7252
Practice Address - Country:US
Practice Address - Phone:253-697-8620
Practice Address - Fax:253-697-8630
Is Sole Proprietor?:No
Enumeration Date:2007-11-20
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health