Provider Demographics
NPI:1083197776
Name:FLAKER, ERICH (MA,CAA)
Entity Type:Individual
Prefix:
First Name:ERICH
Middle Name:
Last Name:FLAKER
Suffix:
Gender:M
Credentials:MA,CAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4233B 324TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:FALL CITY
Mailing Address - State:WA
Mailing Address - Zip Code:98024-8719
Mailing Address - Country:US
Mailing Address - Phone:310-408-1930
Mailing Address - Fax:
Practice Address - Street 1:13343 NE BEL RED RD
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2274
Practice Address - Country:US
Practice Address - Phone:206-461-4880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-10
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60739919101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor