Healthcare Provider Details

I. General information

NPI: 1225019458
Provider Name (Legal Business Name): PAMELA BETTY PASTORE N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2005
Last Update Date: 09/23/2020
Certification Date: 09/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N COLUMBIA RIVER HWY
SAINT HELENS OR
97051-1299
US

IV. Provider business mailing address

500 N COLUMBIA RIVER HWY
SAINT HELENS OR
97051-1299
US

V. Phone/Fax

Practice location:
  • Phone: 503-397-0471
  • Fax:
Mailing address:
  • Phone: 503-397-0471
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number201350067NP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: