Provider Demographics
NPI:1396889879
Name:VALDEZ, PAMELA KAY (DC)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:KAY
Last Name:VALDEZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:KAY
Other - Last Name:KUHNS-VALDEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:246 BENT AVE
Mailing Address - Street 2:P.O. BOX 327
Mailing Address - City:LAS ANIMAS
Mailing Address - State:CO
Mailing Address - Zip Code:81054-1134
Mailing Address - Country:US
Mailing Address - Phone:719-456-2388
Mailing Address - Fax:719-456-1717
Practice Address - Street 1:246 BENT AVE
Practice Address - Street 2:
Practice Address - City:LAS ANIMAS
Practice Address - State:CO
Practice Address - Zip Code:81054
Practice Address - Country:US
Practice Address - Phone:719-456-2388
Practice Address - Fax:719-456-1717
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0001600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COM16130OtherPINNACOLE INSURANCE
COP-60505Medicare UPIN
COC14093Medicare PIN