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Individual

PAMELA THOGMARTIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
371 PATRICIA LN, EAGLE POINT, OR 97524-6619
(619) 961-6554
Mailing address
371 PATRICIA LN, EAGLE POINT, OR 97524-6619

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
OR
175T00000X
Peer Specialist
Primary
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
175T00000X
OR
Enumeration date
09/25/2017
Last updated
04/05/2019
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