Healthcare Provider Details

I. General information

NPI: 1801993233
Provider Name (Legal Business Name): ERICA OBERG ND MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 02/04/2022
Certification Date: 02/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 PROSPECT ST STE 302
LA JOLLA CA
92037-4264
US

IV. Provider business mailing address

726 BROADWAY STE 301
SEATTLE WA
98122
US

V. Phone/Fax

Practice location:
  • Phone: 858-215-4935
  • Fax: 206-726-9434
Mailing address:
  • Phone: 206-726-0034
  • Fax: 206-726-9434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNT00001220
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: