Provider Demographics
NPI:1891899985
Name:BOWEN, PAMELA ANN (PT)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:ANN
Last Name:BOWEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:630-296-2223
Mailing Address - Fax:630-759-9510
Practice Address - Street 1:4999 SKYLINE RD S
Practice Address - Street 2:SUITE 90
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97306-2878
Practice Address - Country:US
Practice Address - Phone:503-566-7700
Practice Address - Fax:503-566-7703
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1450225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist