Healthcare Provider Details

I. General information

NPI: 1770904443
Provider Name (Legal Business Name): ERIK LIND PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/26/2013
Last Update Date: 04/27/2021
Certification Date: 04/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5316 RAINIER AVE S
SEATTLE WA
98118-2354
US

IV. Provider business mailing address

5316 RAINIER AVE S
SEATTLE WA
98118-2354
US

V. Phone/Fax

Practice location:
  • Phone: 206-721-5600
  • Fax:
Mailing address:
  • Phone: 206-721-5600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number60953880
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: