Provider Demographics
NPI:1932392172
Name:PAM RATHBONE WHCNP PC
Entity type:Organization
Organization Name:PAM RATHBONE WHCNP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/NP
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:J
Authorized Official - Last Name:RATHBONE
Authorized Official - Suffix:
Authorized Official - Credentials:WHCNP
Authorized Official - Phone:503-905-2526
Mailing Address - Street 1:15 82ND DR STE 100
Mailing Address - Street 2:
Mailing Address - City:GLADSTONE
Mailing Address - State:OR
Mailing Address - Zip Code:97027-2550
Mailing Address - Country:US
Mailing Address - Phone:503-905-2526
Mailing Address - Fax:503-974-3256
Practice Address - Street 1:15 82ND DR STE 100
Practice Address - Street 2:
Practice Address - City:GLADSTONE
Practice Address - State:OR
Practice Address - Zip Code:97027-2550
Practice Address - Country:US
Practice Address - Phone:503-905-2526
Practice Address - Fax:503-974-3256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR092006979N7261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR131392Medicare PIN