Provider Demographics
NPI:1770055196
Name:POMERANTZ, ESTHER MARGRETHE (AAS)
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:MARGRETHE
Last Name:POMERANTZ
Suffix:
Gender:F
Credentials:AAS
Other - Prefix:
Other - First Name:ESTHER
Other - Middle Name:MARGRETHE
Other - Last Name:HAGEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1007 KOALA DR
Mailing Address - Street 2:
Mailing Address - City:OMAK
Mailing Address - State:WA
Mailing Address - Zip Code:98841-9247
Mailing Address - Country:US
Mailing Address - Phone:509-826-6191
Mailing Address - Fax:509-826-3029
Practice Address - Street 1:1007 KOALA DR
Practice Address - Street 2:
Practice Address - City:OMAK
Practice Address - State:WA
Practice Address - Zip Code:98841-9247
Practice Address - Country:US
Practice Address - Phone:509-826-6191
Practice Address - Fax:509-826-3029
Is Sole Proprietor?:No
Enumeration Date:2018-12-24
Last Update Date:2018-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60878227171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator