Provider Demographics
NPI:1346361086
Name:CASEY, ERICA RAE (MD)
Entity Type:Individual
Prefix:DR
First Name:ERICA
Middle Name:RAE
Last Name:CASEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 E MADISON ST
Mailing Address - Street 2:UNIT 312
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-3191
Mailing Address - Country:US
Mailing Address - Phone:919-433-7249
Mailing Address - Fax:
Practice Address - Street 1:1818 E MADISON ST
Practice Address - Street 2:UNIT 312
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-3191
Practice Address - Country:US
Practice Address - Phone:919-433-7249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60224047207PE0004X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1346361086Medicaid
IL$$$$$$$$$Medicaid
MO147480015Medicare PIN
MO1346361086Medicaid