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General NPI Number Information
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NPI Number | 1144780255
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Entity Type | Individual
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Provider Name | JASON VANG-ERICKSON RN-BSN, PP-NP
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Gender | Male
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Dates
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Enumeration Date | 03/23/2019
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 35859 HIGHWAY 58
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City | PLEASANT HILL
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State | OR
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Zip | 97455-9651
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Country | US
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Telephone | 541-767-5200
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Fax | 541-937-1370
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Provider Business Mailing Address
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Address Line | 2925 CHICAGO AVENUE
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City | MINNEAPOLIS
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State | MN
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Zip | 55407-1321
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Country | US
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Telephone | 612-262-5000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 201905929
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F06191484
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 10290
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License Number State | MN
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