Provider Demographics
NPI:1689718033
Name:SIMONSON, ERYKA LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:ERYKA
Middle Name:LYNN
Last Name:SIMONSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1903 AUSTIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97603-5404
Mailing Address - Country:US
Mailing Address - Phone:541-850-8577
Mailing Address - Fax:541-850-5821
Practice Address - Street 1:1903 AUSTIN ST STE B
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97603-5404
Practice Address - Country:US
Practice Address - Phone:541-850-8577
Practice Address - Fax:541-850-5821
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2014-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3474111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORU68792Medicare UPIN