Healthcare Provider Details

I. General information

NPI: 1144965922
Provider Name (Legal Business Name): ERICA MARIE LATORRE DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2022
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 THRESHER AVE
SILVERDALE WA
98315-2103
US

IV. Provider business mailing address

2100 THRESHER AVE
SILVERDALE WA
98315-2103
US

V. Phone/Fax

Practice location:
  • Phone: 360-315-6023
  • Fax:
Mailing address:
  • Phone: 360-315-6023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number0102208038
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: