Provider Demographics
NPI:1033216833
Name:ERICSON, WILLIAM B JR (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:B
Last Name:ERICSON
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:6100 219TH ST SW
Mailing Address - Street 2:ERICSON HAND AND NERVE CENTER
Mailing Address - City:MOUNTLAKE TERRACE
Mailing Address - State:WA
Mailing Address - Zip Code:98043-2222
Mailing Address - Country:US
Mailing Address - Phone:425-776-4444
Mailing Address - Fax:206-569-4683
Practice Address - Street 1:6100 219TH ST SW
Practice Address - Street 2:ERICSON HAND AND NERVE CENTER
Practice Address - City:MOUNTLAKE TERRACE
Practice Address - State:WA
Practice Address - Zip Code:98043-2222
Practice Address - Country:US
Practice Address - Phone:425-776-4444
Practice Address - Fax:206-569-4683
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-08-17
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Provider Licenses
StateLicense IDTaxonomies
WA00044072207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8858300Medicare ID - Type Unspecified