Provider Demographics
NPI:1811923238
Name:DENTON, PAM
Entity type:Individual
Prefix:
First Name:PAM
Middle Name:
Last Name:DENTON
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 1:12023 100TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-3811
Mailing Address - Country:US
Mailing Address - Phone:425-231-6228
Mailing Address - Fax:
Practice Address - Street 1:17788 147TH ST SE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-1030
Practice Address - Country:US
Practice Address - Phone:360-794-7351
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA00057024183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician