MEDICARE: DANIELLE LAURE ERB MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	MD16721	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003850074
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE LAURE ERB MD

Provider Business Mailing Address
First Line	:	1815 SW MARLOW AVE
Second Line	:	SUITE 110
City	:	PORTLAND
State	:	OR
Zip	:	97225-5185
Country	:	US
Telephone Number	:	503-296-0918
Fax Number	:	503-296-6158

Provider Business Practice Location Address
First Line	:	1815 SW MARLOW AVE
Second Line	:	SUITE 110
City	:	PORTLAND
State	:	OR
Zip	:	97225-5185
Country	:	US
Telephone Number	:	503-296-0918
Fax Number	:	503-296-6158

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2006
Last Update Date	:	06/11/2014

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