Individual
PAMELA JEAN RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
15 CRATER LAKE AVE, MEDFORD, OR 97504-7444
(541) 770-5100
(541) 770-5070
Mailing address
15 CRATER LAKE AVE, MEDFORD, OR 97504-7444
(541) 770-5100
(541) 770-5070
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
200650041NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200650041NP
STATE NP LICENSE
OR
Enumeration date
10/18/2006
Last updated
11/14/2019
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