Provider Demographics
NPI:1043091101
Name:TSIKIRAI, ERICA
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:TSIKIRAI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25808 NE 230TH ST
Mailing Address - Street 2:
Mailing Address - City:BATTLE GROUND
Mailing Address - State:WA
Mailing Address - Zip Code:98604-3958
Mailing Address - Country:US
Mailing Address - Phone:503-347-3581
Mailing Address - Fax:
Practice Address - Street 1:25808 NE 230TH ST
Practice Address - Street 2:
Practice Address - City:BATTLE GROUND
Practice Address - State:WA
Practice Address - Zip Code:98604-3958
Practice Address - Country:US
Practice Address - Phone:503-347-3581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-13
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00145848163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty