Provider Demographics
NPI:1770741019
Name:RANEY, PAMELA KAY (MAC)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:KAY
Last Name:RANEY
Suffix:
Gender:F
Credentials:MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:543 3RD COURT FI
Mailing Address - Street 2:
Mailing Address - City:FOX ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98333-9761
Mailing Address - Country:US
Mailing Address - Phone:253-303-0060
Mailing Address - Fax:
Practice Address - Street 1:3412 56TH ST NW STE 104
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-8210
Practice Address - Country:US
Practice Address - Phone:253-225-2285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health