Individual
MRS. PAMELA ANN DERAITA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
97928 SHOPPING CENTER AVE, HARBOR, OR 97415-9412
(541) 469-4030
(541) 412-0670
Mailing address
PO BOX 2745, 97928 SHOPPING CENTER AVENUE, HARBOR, OR 97415-0326
(541) 469-4030
(541) 412-0670
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
HASP248590
OR
Other
Enumeration date
02/02/2007
Last updated
07/08/2007
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