Individual
MS. PAMELA JO POUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
EFDA
Contact information
Practice address
1063 MOUNTAIN VIEW LN, MOLALLA, OR 97038-7375
(503) 829-5075
Mailing address
1063 MOUNTAIN VIEW LANE, MOLALLA, OR 97038
(503) 829-5075
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
A7688
OR
Other
Enumeration date
03/13/2007
Last updated
07/08/2007
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