Provider Demographics
NPI:1477766970
Name:STREET, ERIKA K (LMP)
Entity Type:Individual
Prefix:MISS
First Name:ERIKA
Middle Name:K
Last Name:STREET
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5410 CALIFORNIA AVE SW STE 204
Mailing Address - Street 2:7901 DELRIDGE WAY SW 26B SEATTLE WA 98106
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98136-1562
Mailing Address - Country:US
Mailing Address - Phone:206-935-2247
Mailing Address - Fax:
Practice Address - Street 1:5410 CALIFORNIA AVE SW STE 204
Practice Address - Street 2:7901 DELRIDGE WAY SW 26B SEATTLE WA 98106
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98136-1562
Practice Address - Country:US
Practice Address - Phone:206-935-2247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00009863174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist