Active NPI
Pamela Jo Poul, EFDA
- Dental Assistant
- Molalla, OR
National Provider Identifier
1093848798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- License
- A7688
- Practice address
- 1063 Mountain View LN
Molalla, OR 97038-7375 - Phone
- (503) 829-5075
- NPI assigned
- Mar 13, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Assistant | 126800000X | A7688 | OR | Primary |
Addresses
Primary practice location
1063 Mountain View LN
Molalla, OR 97038-7375
Mailing address
1063 Mountain View Lane
Molalla, OR 97038
Phone (503) 829-5075
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A7688 | OR | MD | Dental Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1093848798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1063 MOUNTAIN VIEW LANE",
"city": "MOLALLA",
"state": "OR",
"postal_code": "97038",
"telephone_number": "503-829-5075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1063 MOUNTAIN VIEW LN",
"city": "MOLALLA",
"state": "OR",
"postal_code": "970387375",
"telephone_number": "503-829-5075"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POUL",
"first_name": "PAMELA",
"middle_name": "JO",
"name_prefix": "Ms.",
"credential": "EFDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": "OR",
"license": "A7688",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Molalla, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.