Provider Demographics
NPI:1831297928
Name:LILJA, ERIK CHRISTOPHER (DPM)
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:CHRISTOPHER
Last Name:LILJA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 50095
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98145-5095
Mailing Address - Country:US
Mailing Address - Phone:206-520-5700
Mailing Address - Fax:
Practice Address - Street 1:400 N 34TH ST STE 203
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8600
Practice Address - Country:US
Practice Address - Phone:206-520-5000
Practice Address - Fax:206-527-2850
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPO0000746213E00000X
WAPO00000746213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1831297928Medicaid
WAGAB38486Medicare ID - Type Unspecified
WA8350456Medicaid