Healthcare Provider Details

I. General information

NPI: 1710455902
Provider Name (Legal Business Name): ABBY LYNETTE ERICKSON BA, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2018
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2624 N DIVISION ST # 1100
SPOKANE WA
99207-2129
US

IV. Provider business mailing address

2624 N DIVISION ST # 1100
SPOKANE WA
99207-2129
US

V. Phone/Fax

Practice location:
  • Phone: 509-850-0112
  • Fax:
Mailing address:
  • Phone: 509-850-0112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH60792078
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: