MEDICARE: DR. WILLIAM B. ERICSON JR. M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	00044072	WA

General Provider Information

NPI Number	:	1033216833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM B. ERICSON JR. M.D.

Provider Business Mailing Address
First Line	:	6100 219TH ST SW
Second Line	:	ERICSON HAND AND NERVE CENTER
City	:	MOUNTLAKE TERRACE
State	:	WA
Zip	:	98043-2222
Country	:	US
Telephone Number	:	425-776-4444
Fax Number	:	206-569-4683

Provider Business Practice Location Address
First Line	:	6100 219TH ST SW
Second Line	:	ERICSON HAND AND NERVE CENTER
City	:	MOUNTLAKE TERRACE
State	:	WA
Zip	:	98043-2222
Country	:	US
Telephone Number	:	425-776-4444
Fax Number	:	206-569-4683

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	08/17/2007

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