Healthcare Provider Details

I. General information

NPI: 1750983854
Provider Name (Legal Business Name): ROBIN DELL ERICKSON ND, LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2020
Last Update Date: 05/23/2021
Certification Date: 05/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3003 WILLAMETTE ST
EUGENE OR
97405
US

IV. Provider business mailing address

30 E 33RD AVE UNIT 50742
EUGENE OR
97405-6615
US

V. Phone/Fax

Practice location:
  • Phone: 541-678-4850
  • Fax:
Mailing address:
  • Phone: 541-678-4850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number22824
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number4393
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: