Provider Demographics
NPI:1649616954
Name:ADAMS, ERIN MARIE (CNA, LMP)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:MARIE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:CNA, LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5847 GLENMORE DR SE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-5371
Mailing Address - Country:US
Mailing Address - Phone:360-250-1783
Mailing Address - Fax:
Practice Address - Street 1:1317 4TH AVE E
Practice Address - Street 2:#B
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-4245
Practice Address - Country:US
Practice Address - Phone:360-250-1783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-14
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA603281371174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist