Healthcare Provider Details

I. General information

NPI: 1801702493
Provider Name (Legal Business Name): JODI KRISTINE ERICKSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3888 NW RANDALL WAY STE 201
SILVERDALE WA
98383-7847
US

IV. Provider business mailing address

3888 NW RANDALL WAY STE 201
SILVERDALE WA
98383-7847
US

V. Phone/Fax

Practice location:
  • Phone: 306-698-5883
  • Fax:
Mailing address:
  • Phone: 360-698-5883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: