Healthcare Provider Details

I. General information

NPI: 1558346411
Provider Name (Legal Business Name): ERIKA PATTERSON PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 05/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

873 NW GRANT AVE STE A
CORVALLIS OR
97330
US

IV. Provider business mailing address

873 NW GRANT AVE STE A
CORVALLIS OR
97330-4573
US

V. Phone/Fax

Practice location:
  • Phone: 573-356-5536
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number2826
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: