| Doctor Name: | MRS. PAMELA ANN DERAITA |
| NPI Number: | 1295873065 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | HASP248590 |
| Business Practice Address: | 97928 Shopping Center Ave Harbor, OR - 974159412 |
| Business Phone Number: | 5414694030 |
| Business Fax Number: | 5414120670 |
| Mailing Address: | Po Box 2745, 97928 Shopping Center Avenue HARBOR |
| State: | OR |
| Postal Code: | 974150326 |
| Phone Number: | 5414694030 |
| Fax Number: | 5414120670 |
| NPI Enumeration Date: | 02/02/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 237700000X |
| License Number: | HASP248590 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Hearing Instrument Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | Individuals who test hearing for the selection, adaptation, fitting, adjusting, servicing, and sale of hearing aids. Hearing Instrument Specialist is a designation provided individuals who qualify by the National Hearing Aid Society |