Provider Demographics
NPI:1326320052
Name:MCPEAK, ERIN C (PA-C)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:C
Last Name:MCPEAK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12405 SE 2ND CIR
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-6064
Mailing Address - Country:US
Mailing Address - Phone:360-839-4532
Mailing Address - Fax:855-598-3606
Practice Address - Street 1:12405 SE 2ND CIR
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-6064
Practice Address - Country:US
Practice Address - Phone:360-839-4532
Practice Address - Fax:855-598-3606
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA60276548363A00000X
LA304668363AS0400X
CAPA54168363AS0400X
IL085004106363A00000X
ORPA157792363A00000X
IN10001396A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical