Provider Demographics
NPI:1700152808
Name:ARAGON, PAMELA H (LMP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:H
Last Name:ARAGON
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:975 SE PASEK ST
Mailing Address - Street 2:APT 1
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-5468
Mailing Address - Country:US
Mailing Address - Phone:360-929-3429
Mailing Address - Fax:
Practice Address - Street 1:840 SE BAYSHORE DR
Practice Address - Street 2:STE 101
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-4062
Practice Address - Country:US
Practice Address - Phone:360-929-3429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-22
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00019310225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist