Pamela Ann Deraita

Individual provider Active NPI Hearing Instrument Specialist · Harbor, OR

NPI 1295873065 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1295873065
Entity type
Individual (NPI type 1)
Primary specialty
Hearing Instrument Specialist 237700000X
License
HASP248590 (OR)
Practice address
97928 Shopping Center Ave
Harbor, OR 97415-9412
Phone
(541) 469-4030
Fax
(541) 412-0670
NPI assigned
Feb 2, 2007
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
HASP248590ORMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Hearing Health Care, Inc Hearing Instrument Specialist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X HASP248590 OR Yes

Addresses

Primary practice location

97928 Shopping Center Ave
Harbor, OR 97415-9412

Mailing address

PO Box 2745
97928 Shopping Center Avenue
Harbor, OR 97415-0326
Phone (541) 469-4030

Other providers in Harbor, OR

All providers in Harbor, OR · Hearing Instrument Specialist in Oregon

Sources for this page

Verify at the official NPI Registry.