Provider Demographics
NPI:1427806280
Name:WEST, PAMELA LYNN
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:LYNN
Last Name:WEST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 N MAPLE AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18704-3633
Mailing Address - Country:US
Mailing Address - Phone:570-871-2714
Mailing Address - Fax:
Practice Address - Street 1:400 3RD AVE
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:PA
Practice Address - Zip Code:18704-5816
Practice Address - Country:US
Practice Address - Phone:570-904-3594
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker