Provider Demographics
NPI:1780632661
Name:PRICE, PAMELA DIANA (PHD LAC DIPLAC)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:DIANA
Last Name:PRICE
Suffix:
Gender:F
Credentials:PHD LAC DIPLAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4676 COMMERCIAL ST SE
Mailing Address - Street 2:STE 185
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-1902
Mailing Address - Country:US
Mailing Address - Phone:503-365-0848
Mailing Address - Fax:503-763-9160
Practice Address - Street 1:401 RATCLIFF DR SE
Practice Address - Street 2:STE 130
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-4581
Practice Address - Country:US
Practice Address - Phone:503-365-0845
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR576171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist