Provider Demographics
NPI:1518737212
Name:ELDRIDGE-ERICKSON, AMELIA ERYN
Entity Type:Individual
Prefix:MISS
First Name:AMELIA
Middle Name:ERYN
Last Name:ELDRIDGE-ERICKSON
Suffix:
Gender:F
Credentials:
Other - Prefix:MR
Other - First Name:AARON
Other - Middle Name:J
Other - Last Name:ELDRIDGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9300 NE OAK VIEW DR
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-6157
Mailing Address - Country:US
Mailing Address - Phone:360-567-2211
Mailing Address - Fax:
Practice Address - Street 1:9300 NE OAK VIEW DR
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-6157
Practice Address - Country:US
Practice Address - Phone:360-567-2211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-03
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist