Provider Demographics
NPI:1346516630
Name:PUGH, ERIN MARIE (ATC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:MARIE
Last Name:PUGH
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4316 S 41ST ST
Mailing Address - Street 2:#4
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98409-2164
Mailing Address - Country:US
Mailing Address - Phone:509-270-8316
Mailing Address - Fax:
Practice Address - Street 1:4316 S 41ST ST
Practice Address - Street 2:#4
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409-2164
Practice Address - Country:US
Practice Address - Phone:509-270-8316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-30
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer