Provider Demographics
NPI:1467711291
Name:ERICKSON, RACHEL JESSICA (ND, EAMP)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:JESSICA
Last Name:ERICKSON
Suffix:
Gender:F
Credentials:ND, EAMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 22ND AVE E APT B
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-5321
Mailing Address - Country:US
Mailing Address - Phone:503-754-0342
Mailing Address - Fax:
Practice Address - Street 1:131 22ND AVE E APT B
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-5321
Practice Address - Country:US
Practice Address - Phone:503-754-0342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-14
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1855175F00000X
WANT 60284357175F00000X
WAAC 60292130171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist