Healthcare Provider Details

I. General information

NPI: 1356494314
Provider Name (Legal Business Name): PAMELA Z. PAETZHOLD D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2007
Last Update Date: 02/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1832 WILLAMETTE FALLS DR
WEST LINN OR
97068-4660
US

IV. Provider business mailing address

1832 WILLAMETTE FALLS DR
WEST LINN OR
97068-4660
US

V. Phone/Fax

Practice location:
  • Phone: 503-557-8444
  • Fax: 503-557-8461
Mailing address:
  • Phone: 503-557-8444
  • Fax: 503-557-8461

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1820
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code111NI0900X
TaxonomyInternist Chiropractor
License Number1820
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number0634
License Number StateOR
# 4
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC00073
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: