MEDICARE: PEGGY ELAINE ERICKSON LMT

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	225700000X	Massage Therapist	MA00013808	WA
2	224Z00000X	Occupational Therapy Assistant		WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0154493	OTHER	WA	STATE L & I

General Provider Information

NPI Number	:	1821206186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PEGGY ELAINE ERICKSON LMT

Provider Business Mailing Address
First Line	:	314 E 4TH
Second Line	:
City	:	ELLENSBURG
State	:	WA
Zip	:	98926
Country	:	US
Telephone Number	:	509-925-4394
Fax Number	:

Provider Business Practice Location Address
First Line	:	314 E 4TH
Second Line	:
City	:	ELLENSBURG
State	:	WA
Zip	:	98926
Country	:	US
Telephone Number	:	509-925-4394
Fax Number	:

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

Provider Enumeration Date	:	05/18/2007
Last Update Date	:	09/11/2025

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