Provider Demographics
NPI:1164692950
Name:NULF, ERIN MONICA (PA-C)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:MONICA
Last Name:NULF
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:M
Other - Last Name:MCCLAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:757 E HOLLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1257
Mailing Address - Country:US
Mailing Address - Phone:509-444-6367
Mailing Address - Fax:509-444-6371
Practice Address - Street 1:757 E HOLLAND AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1257
Practice Address - Country:US
Practice Address - Phone:509-444-6371
Practice Address - Fax:509-444-6371
Is Sole Proprietor?:No
Enumeration Date:2008-03-07
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA60440358363A00000X
WAOA 60571431363AM0700X
WAPA 60440358363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical