Provider Demographics
NPI:1457799728
Name:LLOREN, PAMELA AISSA (DDS)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:AISSA
Last Name:LLOREN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8439 34TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98126-3757
Mailing Address - Country:US
Mailing Address - Phone:956-655-8866
Mailing Address - Fax:
Practice Address - Street 1:2021 NW MYHRE PL STE 200
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8562
Practice Address - Country:US
Practice Address - Phone:360-779-7414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-10
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29028122300000X
WADR60371551122300000X
WADE604826501223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
No122300000XDental ProvidersDentist