Healthcare Provider Details

I. General information

NPI: 1740117977
Provider Name (Legal Business Name): JOSHUA JAMES ERICSON CPRC-S
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 E POPLAR AVE
COEUR D ALENE ID
83814-3435
US

IV. Provider business mailing address

1464 N LUNA ST
POST FALLS ID
83854-3804
US

V. Phone/Fax

Practice location:
  • Phone: 208-819-6122
  • Fax: 866-605-2375
Mailing address:
  • Phone: 208-416-1134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number13022
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: