Provider Demographics
NPI:1508229170
Name:IRWIN, ERIKA (ATC)
Entity Type:Individual
Prefix:MRS
First Name:ERIKA
Middle Name:
Last Name:IRWIN
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1195 N LUPINE CT
Mailing Address - Street 2:
Mailing Address - City:CANBY
Mailing Address - State:OR
Mailing Address - Zip Code:97013-2935
Mailing Address - Country:US
Mailing Address - Phone:808-230-0938
Mailing Address - Fax:
Practice Address - Street 1:1195 N LUPINE CT
Practice Address - Street 2:
Practice Address - City:CANBY
Practice Address - State:OR
Practice Address - Zip Code:97013-2935
Practice Address - Country:US
Practice Address - Phone:808-230-0938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-31
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAT-AT-101335522255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer