Provider Demographics
NPI:1750749362
Name:QUINN, ERIN MARY (PA-C)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:MARY
Last Name:QUINN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:ERIN
Other - Middle Name:MARY
Other - Last Name:BALCERZAK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C
Mailing Address - Street 1:1401 E TRENT AVE # 200
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-2902
Mailing Address - Country:US
Mailing Address - Phone:509-747-3147
Mailing Address - Fax:
Practice Address - Street 1:1401 E TRENT AVE # 200
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-2902
Practice Address - Country:US
Practice Address - Phone:509-747-3147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-10
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA61221320363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant