Provider Demographics
NPI:1306833090
Name:BYLUND, ERIK ROY (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIK
Middle Name:ROY
Last Name:BYLUND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2116 EAST SECTION STREET
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98274-9124
Mailing Address - Country:US
Mailing Address - Phone:360-428-1700
Mailing Address - Fax:360-848-4350
Practice Address - Street 1:2116 EAST SECTION STREET
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98274-9124
Practice Address - Country:US
Practice Address - Phone:360-428-1700
Practice Address - Fax:360-848-4350
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA68273207Q00000X
WAMD00048310207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8487415Medicaid
WA8487415Medicaid