| Doctor Name: | MRS. PAMELA JEAN WANEK |
| NPI Number: | 1578648499 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | |
| Business Practice Address: | 36530 S.e. Squaw Mt. Rd. Estacada, OR - 970239461 |
| Business Phone Number: | 5036306724 |
| Business Fax Number: | 5036306724 |
| Mailing Address: | 36530 S.e. Squaw Mt. Rd., ESTACADA |
| State: | OR |
| Postal Code: | 970239461 |
| Phone Number: | 5036306724 |
| Fax Number: | 5036306724 |
| NPI Enumeration Date: | 10/26/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC1500X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |