Provider Demographics
NPI:1942962899
Name:ERICKSON, CHRISZMA (LAC)
Entity Type:Individual
Prefix:
First Name:CHRISZMA
Middle Name:
Last Name:ERICKSON
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 NORTHPOINT LOOP
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97327-9783
Mailing Address - Country:US
Mailing Address - Phone:619-971-1660
Mailing Address - Fax:
Practice Address - Street 1:353 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:OR
Practice Address - Zip Code:97327-2152
Practice Address - Country:US
Practice Address - Phone:541-619-0061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-07
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC196598171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist