Provider Demographics
NPI:1891121067
Name:JANSON, ERIK G (ARNP)
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:G
Last Name:JANSON
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 NW MARKET ST STE 101
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-5211
Mailing Address - Country:US
Mailing Address - Phone:800-722-3009
Mailing Address - Fax:
Practice Address - Street 1:1500 NW MARKET ST STE 101
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-5211
Practice Address - Country:US
Practice Address - Phone:800-722-3009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-19
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60405032363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAP01295300OtherRAIL ROAD
WA1891121067Medicaid
WA8925032Medicare PIN
WAP01295300OtherRAIL ROAD
WA8925031Medicare PIN