Healthcare Provider Details

I. General information

NPI: 1942962899
Provider Name (Legal Business Name): CHRISZMA ERICKSON LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2021
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

353 N MAIN ST
BROWNSVILLE OR
97327-2152
US

IV. Provider business mailing address

817 NORTHPOINT LOOP
BROWNSVILLE OR
97327-9783
US

V. Phone/Fax

Practice location:
  • Phone: 541-619-0061
  • Fax:
Mailing address:
  • Phone: 619-971-1660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberAC196598
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC196598
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: