Provider Demographics
NPI:1942610894
Name:LAPORTE, ERICA LAUREN (MS)
Entity Type:Individual
Prefix:MS
First Name:ERICA
Middle Name:LAUREN
Last Name:LAPORTE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7506 37TH AVE NE
Mailing Address - Street 2:#3
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-8025
Mailing Address - Country:US
Mailing Address - Phone:520-404-9679
Mailing Address - Fax:
Practice Address - Street 1:1025 S 3RD ST
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-2765
Practice Address - Country:US
Practice Address - Phone:425-271-5600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-30
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health