Healthcare Provider Details

I. General information

NPI: 1083197776
Provider Name (Legal Business Name): ERICH FLAKER MA,CAA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2018
Last Update Date: 09/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13343 NE BEL RED RD
BELLEVUE WA
98005-2274
US

IV. Provider business mailing address

4233B 324TH AVE SE
FALL CITY WA
98024-8719
US

V. Phone/Fax

Practice location:
  • Phone: 206-461-4880
  • Fax:
Mailing address:
  • Phone: 310-408-1930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberCG60739919
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: