Provider Demographics
NPI:1588719710
Name:DAHM, PAMELA SUSAN (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:SUSAN
Last Name:DAHM
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10264 SW MORATOC DR
Mailing Address - Street 2:
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-8840
Mailing Address - Country:US
Mailing Address - Phone:503-706-4437
Mailing Address - Fax:503-692-5203
Practice Address - Street 1:10264 SW MORATOC DR
Practice Address - Street 2:
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-8840
Practice Address - Country:US
Practice Address - Phone:503-706-4437
Practice Address - Fax:503-692-5203
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR11170235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist