Provider Demographics
NPI:1538665781
Name:HATLESTAD, ERIN SOLVEIG (LMT)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:SOLVEIG
Last Name:HATLESTAD
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1002 5TH ST
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-2250
Mailing Address - Country:US
Mailing Address - Phone:541-410-4250
Mailing Address - Fax:
Practice Address - Street 1:1029 MAY ST
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-1514
Practice Address - Country:US
Practice Address - Phone:541-410-4250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR24191225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist