Provider Demographics
NPI:1891758827
Name:ERICKSON, TIFFANY NICOLE (PHARMD, BCPS)
Entity Type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:NICOLE
Last Name:ERICKSON
Suffix:
Gender:F
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8315 127TH PL SE
Mailing Address - Street 2:
Mailing Address - City:NEWCASTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98056-9155
Mailing Address - Country:US
Mailing Address - Phone:206-731-8120
Mailing Address - Fax:206-731-8689
Practice Address - Street 1:325 9TH AVE
Practice Address - Street 2:BOX 359912
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2420
Practice Address - Country:US
Practice Address - Phone:206-731-8120
Practice Address - Fax:206-731-8689
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH000415021835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy