Provider Demographics
NPI:1023557238
Name:MCKIM, ERYN CLAIRE (RN)
Entity Type:Individual
Prefix:MS
First Name:ERYN
Middle Name:CLAIRE
Last Name:MCKIM
Suffix:
Gender:F
Credentials:RN
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Mailing Address - Street 1:3181 SW SAM JACKSON PARK RD
Mailing Address - Street 2:MAIL CODE L-461
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-3011
Mailing Address - Country:US
Mailing Address - Phone:503-494-4373
Mailing Address - Fax:503-346-6914
Practice Address - Street 1:3181 SW SAM JACKSON PARK RD
Practice Address - Street 2:MAIL CODE L-461
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3011
Practice Address - Country:US
Practice Address - Phone:503-494-4373
Practice Address - Fax:503-346-6914
Is Sole Proprietor?:No
Enumeration Date:2017-02-21
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OR095003033RN163WG0100X, 163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
No163WG0100XNursing Service ProvidersRegistered NurseGastroenterology