Provider Demographics
NPI:1790816999
Name:CHRISTENSEN, PAMELA S (MA)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:S
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:194 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:OR
Mailing Address - Zip Code:97103-6114
Mailing Address - Country:US
Mailing Address - Phone:503-791-8833
Mailing Address - Fax:503-325-8028
Practice Address - Street 1:194 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:OR
Practice Address - Zip Code:97103-6114
Practice Address - Country:US
Practice Address - Phone:503-791-8833
Practice Address - Fax:503-325-8028
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC1720101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health