Provider Demographics
NPI:1477769560
Name:FLEURANTIN ERISCA, CLAUDIA MARY (OD)
Entity Type:Individual
Prefix:DR
First Name:CLAUDIA
Middle Name:MARY
Last Name:FLEURANTIN ERISCA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6715 141ST ST SE
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98296-8961
Mailing Address - Country:US
Mailing Address - Phone:425-357-1220
Mailing Address - Fax:
Practice Address - Street 1:1175 N 205TH ST
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-3206
Practice Address - Country:US
Practice Address - Phone:206-533-8170
Practice Address - Fax:206-971-5068
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 4129152W00000X
WA3681TX152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist