Provider Demographics
NPI:1609030980
Name:RANGEL, PAMELA LOUISE (QMHA)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:LOUISE
Last Name:RANGEL
Suffix:
Gender:F
Credentials:QMHA
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 1013
Mailing Address - Street 2:
Mailing Address - City:NORTH BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97459-0077
Mailing Address - Country:US
Mailing Address - Phone:541-217-1126
Mailing Address - Fax:541-751-7905
Practice Address - Street 1:1840 UNION AVE
Practice Address - Street 2:
Practice Address - City:NORTH BEND
Practice Address - State:OR
Practice Address - Zip Code:97459-3422
Practice Address - Country:US
Practice Address - Phone:541-217-1126
Practice Address - Fax:541-751-7905
Is Sole Proprietor?:No
Enumeration Date:2008-07-15
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health