Provider Demographics
NPI:1154666311
Name:LAGACE, ERIK (BS)
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:
Last Name:LAGACE
Suffix:
Gender:M
Credentials:BS
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 400
Mailing Address - Street 2:8001 SILVA AVE S E
Mailing Address - City:SNOQUALMIE
Mailing Address - State:WA
Mailing Address - Zip Code:98065-0400
Mailing Address - Country:US
Mailing Address - Phone:425-831-8000
Mailing Address - Fax:425-831-8040
Practice Address - Street 1:8001 SILVA AVE S E
Practice Address - Street 2:
Practice Address - City:SNOQUALMIE
Practice Address - State:WA
Practice Address - Zip Code:98065-0400
Practice Address - Country:US
Practice Address - Phone:425-831-8000
Practice Address - Fax:425-831-8040
Is Sole Proprietor?:No
Enumeration Date:2012-11-29
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00002693225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist