Provider Demographics
NPI:1205205895
Name:ERICKSON, SIGNY (DC)
Entity Type:Individual
Prefix:DR
First Name:SIGNY
Middle Name:
Last Name:ERICKSON
Suffix:
Gender:F
Credentials:DC
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 8488
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97708-8488
Mailing Address - Country:US
Mailing Address - Phone:541-410-5445
Mailing Address - Fax:
Practice Address - Street 1:1334 NE REVERE AVE
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-4154
Practice Address - Country:US
Practice Address - Phone:541-410-5445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-24
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2577111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor