Provider Demographics
NPI:1568887040
Name:DUNSMORE, ERICA LOUISE (LMT)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:LOUISE
Last Name:DUNSMORE
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 1:525 GLEN CREEK RD NW
Mailing Address - Street 2:SUITE 230
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97304-3161
Mailing Address - Country:US
Mailing Address - Phone:503-339-7376
Mailing Address - Fax:503-217-0364
Practice Address - Street 1:525 GLEN CREEK RD NW
Practice Address - Street 2:SUITE 230
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97304-3161
Practice Address - Country:US
Practice Address - Phone:503-339-7376
Practice Address - Fax:503-217-0364
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-20
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORLMT #11649171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor