Provider Demographics
NPI:1356956742
Name:STANTON, ERIN CAASSIDY
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:CAASSIDY
Last Name:STANTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:CASSIDY
Other - Last Name:CHASTAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21872 S MIJA LN
Mailing Address - Street 2:
Mailing Address - City:ESTACADA
Mailing Address - State:OR
Mailing Address - Zip Code:97023-9607
Mailing Address - Country:US
Mailing Address - Phone:971-279-0881
Mailing Address - Fax:
Practice Address - Street 1:21872 S MIJA LN
Practice Address - Street 2:
Practice Address - City:ESTACADA
Practice Address - State:OR
Practice Address - Zip Code:97023-9607
Practice Address - Country:US
Practice Address - Phone:971-279-0881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-11
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR374J00000XOtherDOULA