Pamela Ann Deraita

Primary specialty

Hearing Instrument SpecialistTaxonomy code 237700000X

License

HASP248590 Issued in OR

Practice address

97928 Shopping Center Ave
Harbor, OR 97415-9412

Phone

(541) 469-4030

Fax

(541) 412-0670

NPI assigned

Feb 2, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Hearing Health Care, Inc

  • Hearing Instrument Specialist
  • Crescent City, CA
  • NPI 1447476569
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295873065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2745",
            "address_2": "97928 SHOPPING CENTER AVENUE",
            "city": "HARBOR",
            "state": "OR",
            "postal_code": "974150326",
            "telephone_number": "541-469-4030",
            "fax_number": "541-412-0670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97928 SHOPPING CENTER AVE",
            "city": "HARBOR",
            "state": "OR",
            "postal_code": "974159412",
            "telephone_number": "541-469-4030",
            "fax_number": "541-412-0670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERAITA",
        "first_name": "PAMELA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "OR",
            "license": "HASP248590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barrons Home Furnishings
• Brookings Internal Medicine-Pathology-Diseases of the Skin
• William H Carrigan, MA
• Julianna K Clark, PHARMD
• Sung Sheng Ho, PHARMD
• Ausama Khalil
• Susan B. Krayer, LPC
• Megan Land, LMT#29299
• Lincare Inc.

• Hearing Instrument Specialist in Harbor, OR
• Providers in Harbor, OR by specialty
• Hearing Instrument Specialist in Oregon

• 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.

Verify at the official NPI Registry.