Provider Demographics
NPI:1801831508
Name:BUTLER, PAMELA (DMD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:
Last Name:BUTLER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3205 SE 192ND AVE
Mailing Address - Street 2:SUITE#100
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683
Mailing Address - Country:US
Mailing Address - Phone:360-891-9283
Mailing Address - Fax:360-891-8030
Practice Address - Street 1:3205 SE 192ND AVE
Practice Address - Street 2:SUITE#100
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683
Practice Address - Country:US
Practice Address - Phone:360-891-9283
Practice Address - Fax:360-891-8030
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD69411223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry