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NPI Code Detail

MEDICARE: ERICA LYNN SIMONICH WHNP

MEDICARE: ERICA LYNN SIMONICH WHNP
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
1363L00000XNurse PractitionerAP60577137WA
2363LW0102XWomen's Health Nurse Practitioner721409TX
3363LW0102XWomen's Health Nurse Practitioner201400201NP-PPOR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396083242
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERICA LYNN SIMONICH WHNP
Provider Business Mailing Address
First Line : 1901 N KILLINGSWORTH ST
Second Line :
City : PORTLAND
State : OR
Zip : 97217-4436
Country : US
Telephone Number : 503-770-0670
Fax Number : 833-450-6082
Provider Business Practice Location Address
First Line : 1901 N KILLINGSWORTH ST
Second Line :
City : PORTLAND
State : OR
Zip : 97217-4436
Country : US
Telephone Number : 503-770-0670
Fax Number : 833-450-6082
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/28/2013
Last Update Date : 03/30/2025

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