Provider Demographics
NPI:1245431170
Name:PRESTON, ERICA ANN
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:ANN
Last Name:PRESTON
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:ERICA
Other - Middle Name:ANN
Other - Last Name:CHRISTENSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ATC
Mailing Address - Street 1:14721 1ST LN NE
Mailing Address - Street 2:#105
Mailing Address - City:DUVALL
Mailing Address - State:WA
Mailing Address - Zip Code:98019-6451
Mailing Address - Country:US
Mailing Address - Phone:425-844-1160
Mailing Address - Fax:
Practice Address - Street 1:4455 148TH AVE NE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-3120
Practice Address - Country:US
Practice Address - Phone:425-861-6254
Practice Address - Fax:425-861-6277
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer