Healthcare Provider Details

I. General information

NPI: 1679827646
Provider Name (Legal Business Name): PAMELLA R. HOWARD PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2012
Last Update Date: 09/06/2023
Certification Date: 09/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 E FOURTH PLAIN BLVD
VANCOUVER WA
98661-3713
US

IV. Provider business mailing address

913 NW GARDEN VALLEY BLVD
ROSEBURG OR
97471-6523
US

V. Phone/Fax

Practice location:
  • Phone: 360-696-4061
  • Fax:
Mailing address:
  • Phone: 541-440-1000
  • Fax: 541-440-1273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY60624638
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: