Healthcare Provider Details

I. General information

NPI: 1134130941
Provider Name (Legal Business Name): ERIKA M ANATTOL ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6040 S FIFE ST
TACOMA WA
98409-6130
US

IV. Provider business mailing address

6040 S FIFE ST
TACOMA WA
98409-6130
US

V. Phone/Fax

Practice location:
  • Phone: 253-222-5600
  • Fax:
Mailing address:
  • Phone: 253-222-5600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: