Provider Demographics
NPI:1942395884
Name:ROSSIO, PAMELA J (PMHNP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:J
Last Name:ROSSIO
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 OAK ST STE 205
Mailing Address - Street 2:
Mailing Address - City:CENTRAL POINT
Mailing Address - State:OR
Mailing Address - Zip Code:97502-2542
Mailing Address - Country:US
Mailing Address - Phone:541-787-2997
Mailing Address - Fax:541-787-2989
Practice Address - Street 1:312 OAK ST STE 205
Practice Address - Street 2:
Practice Address - City:CENTRAL POINT
Practice Address - State:OR
Practice Address - Zip Code:97502-2542
Practice Address - Country:US
Practice Address - Phone:541-787-2997
Practice Address - Fax:541-727-7529
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1725176B00000X
OR201607430NPPP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No176B00000XOther Service ProvidersMidwife