Healthcare Provider Details

I. General information

NPI: 1538558184
Provider Name (Legal Business Name): ERIN WOS DO, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. ERIN MARY GRAY

II. Dates (important events)

Enumeration Date: 01/21/2015
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 VALLEY RIVER DR STE 220
EUGENE OR
97401-6759
US

IV. Provider business mailing address

1400 VALLEY RIVER DR STE 220
EUGENE OR
97401-6759
US

V. Phone/Fax

Practice location:
  • Phone: 541-603-5577
  • Fax: 541-650-6434
Mailing address:
  • Phone: 541-603-5577
  • Fax: 541-650-6434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberOP61064724
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: