Provider Demographics
NPI:1467503391
Name:ERICKSON, LIANE PATRICIA (ND)
Entity Type:Individual
Prefix:DR
First Name:LIANE
Middle Name:PATRICIA
Last Name:ERICKSON
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:LIANE
Other - Middle Name:
Other - Last Name:ERICKSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ND
Mailing Address - Street 1:511 LEDORA CIR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-3342
Mailing Address - Country:US
Mailing Address - Phone:907-342-6373
Mailing Address - Fax:907-342-6373
Practice Address - Street 1:915 W NORTHERN LIGHTS BLVD
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-2408
Practice Address - Country:US
Practice Address - Phone:907-770-6700
Practice Address - Fax:907-770-6707
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK051208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice