Provider Demographics
NPI:1750983854
Name:ERICKSON, ROBIN DELL (ND, LMT)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:DELL
Last Name:ERICKSON
Suffix:
Gender:F
Credentials:ND, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 E 33RD AVE UNIT 50742
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-6615
Mailing Address - Country:US
Mailing Address - Phone:541-678-4850
Mailing Address - Fax:
Practice Address - Street 1:3003 WILLAMETTE ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405
Practice Address - Country:US
Practice Address - Phone:541-678-4850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-12
Last Update Date:2021-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR22824225700000X
OR4393175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist