Provider Demographics
NPI:1083113468
Name:ELKINS, ERIN K (LM, CPM, MSM)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:K
Last Name:ELKINS
Suffix:
Gender:F
Credentials:LM, CPM, MSM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4045
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98904-4045
Mailing Address - Country:US
Mailing Address - Phone:509-426-4484
Mailing Address - Fax:509-453-1400
Practice Address - Street 1:1510 W YAKIMA AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-2951
Practice Address - Country:US
Practice Address - Phone:509-367-7158
Practice Address - Fax:509-453-1400
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-12
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMW60829748176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2133690Medicaid