Healthcare Provider Details

I. General information

NPI: 1205758752
Provider Name (Legal Business Name): ERIKA LIABRAATEN BSN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 CUNNINGHAM RD
KELSO WA
98626-9611
US

IV. Provider business mailing address

259 PARE RD
KELSO WA
98626-9639
US

V. Phone/Fax

Practice location:
  • Phone: 360-749-0010
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberRN61588861
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN61588861
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: