Healthcare Provider Details

I. General information

NPI: 1669654331
Provider Name (Legal Business Name): ERICKSON'S INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2007
Last Update Date: 04/13/2021
Certification Date: 04/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 W RIVERSIDE AVE STE 770
SPOKANE WA
99201-0402
US

IV. Provider business mailing address

421 W RIVERSIDE AVE STE 770
SPOKANE WA
99201-0402
US

V. Phone/Fax

Practice location:
  • Phone: 509-747-6148
  • Fax: 509-638-6705
Mailing address:
  • Phone: 509-747-6148
  • Fax: 509-638-6705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code156FX1700X
TaxonomyOcularist
License NumberOS 00000010
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number328043554
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number328043554
License Number StateWA

VIII. Authorized Official

Name: MONICA D ERICKSON
Title or Position: PRESIDENT
Credential:
Phone: 509-747-6148