Provider Demographics
NPI:1578777470
Name:ZACHER, PAMELA JOAN (LPTA)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:JOAN
Last Name:ZACHER
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7835 NE PARK LN
Mailing Address - Street 2:
Mailing Address - City:OTIS
Mailing Address - State:OR
Mailing Address - Zip Code:97368-9680
Mailing Address - Country:US
Mailing Address - Phone:541-996-7160
Mailing Address - Fax:
Practice Address - Street 1:3043 N.E. 28TH ST.
Practice Address - Street 2:
Practice Address - City:LINCOLN CITY
Practice Address - State:OR
Practice Address - Zip Code:97367-0769
Practice Address - Country:US
Practice Address - Phone:541-996-7160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR7065225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant