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General NPI Number Information
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NPI Number | 1316390719
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Entity Type | Individual
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Provider Name | SEANNA MAE ERRICSON
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Gender | Female
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Dates
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Enumeration Date | 07/20/2016
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Last Update Date | 03/17/2021
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Provider Practice Location Address
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Address Line | 10892 SE OREGOLD CT
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City | HAPPY VALLEY
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State | OR
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Zip | 97086-6092
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Country | US
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Telephone | 503-320-7020
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Fax | 503-482-5828
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Provider Business Mailing Address
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Address Line | 10892 SE OREGOLD CT
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City | HAPPY VALLEY
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State | OR
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Zip | 97086-6092
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Country | US
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Telephone | 503-320-7020
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Fax | 503-482-5828
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 17662
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License Number State | OR
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