Provider Demographics
NPI:1427604586
Name:WARREN, ERIN JOY (PNP-AC/PC)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:JOY
Last Name:WARREN
Suffix:
Gender:F
Credentials:PNP-AC/PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4399
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-4399
Mailing Address - Country:US
Mailing Address - Phone:503-413-3900
Mailing Address - Fax:503-413-3710
Practice Address - Street 1:2800 N VANCOUVER AVE STE 165
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97227-1644
Practice Address - Country:US
Practice Address - Phone:503-413-2909
Practice Address - Fax:503-413-5220
Is Sole Proprietor?:No
Enumeration Date:2019-08-14
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201810268NP-PP363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics