Provider Demographics
NPI:1033101662
Name:MEYER, ERIKA K (MD)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:K
Last Name:MEYER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ERIKA
Other - Middle Name:LOUISE
Other - Last Name:KEMPLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1130 NW 22ND AVE
Mailing Address - Street 2:STE 320
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-2900
Mailing Address - Country:US
Mailing Address - Phone:503-295-2546
Mailing Address - Fax:503-790-1248
Practice Address - Street 1:1130 NW 22ND AVE
Practice Address - Street 2:STE 320
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-2900
Practice Address - Country:US
Practice Address - Phone:503-295-2546
Practice Address - Fax:503-790-1248
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD24385208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR227478Medicaid
H99249Medicare UPIN
OR227478Medicaid