Provider Demographics
NPI:1013584275
Name:KEYS, PAMELA ANN
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:ANN
Last Name:KEYS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25349 SW OBERST RD
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:OR
Mailing Address - Zip Code:97140-8449
Mailing Address - Country:US
Mailing Address - Phone:971-219-5388
Mailing Address - Fax:
Practice Address - Street 1:25349 SW OBERST RD
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:OR
Practice Address - Zip Code:97140-8449
Practice Address - Country:US
Practice Address - Phone:971-219-5388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-07
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider