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General NPI Number Information
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NPI Number | 1932259587
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Entity Type | Individual
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Provider Name | STEPHEN T ERICKSON MD
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Gender | Male
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 02/26/2013
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Provider Practice Location Address
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Address Line | 1010 SHERIDAN ST SUITE 202
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City | PORT TOWNSEND
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State | WA
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Zip | 98368-2901
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Country | US
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Telephone | 360-385-5388
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Fax | 360-385-0433
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Provider Business Mailing Address
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Address Line | 1010 SHERIDAN ST SUITE 202
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City | PORT TOWNSEND
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State | WA
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Zip | 98368-2901
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Country | US
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Telephone | 360-385-5388
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Fax | 360-385-0433
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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 | 39311
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License Number State | WI
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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 | 48329
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License Number State | CO
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