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General NPI Number Information
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NPI Number | 1831577196
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Entity Type | Individual
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Provider Name | ELIZABETH DIETRICH ERIKSON DO
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Gender | Female
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Dates
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Enumeration Date | 05/07/2015
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 316 N 3RD ST
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City | HAMILTON
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State | MT
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Zip | 59840-2480
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Country | US
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Telephone | 406-541-0032
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Fax | 406-541-0036
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Provider Business Mailing Address
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Address Line | 2111 EXCHANGE ST
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City | ASTORIA
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State | OR
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Zip | 97103-3329
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Country | US
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Telephone | 503-325-4321
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Fax | 406-258-4732
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MED-PHYS-LIC-117581
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 189802
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License Number State | OR
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