Provider Demographics
NPI:1356466106
Name:QUANN, ERIN MELISSA (RN, LMP)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:MELISSA
Last Name:QUANN
Suffix:
Gender:F
Credentials:RN, LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11602 135TH STREET CT E
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98374-3161
Mailing Address - Country:US
Mailing Address - Phone:253-224-1308
Mailing Address - Fax:
Practice Address - Street 1:11602 135TH STREET CT E
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98374-3161
Practice Address - Country:US
Practice Address - Phone:253-224-1308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00008848225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA105848OtherDEPT. OF L & I NUMBER
WA5336QUOtherREGENCE RIDER NUMBER