Provider Demographics
NPI:1841310976
Name:ERSKINE, LORETTA A (LMP)
Entity type:Individual
Prefix:MS
First Name:LORETTA
Middle Name:A
Last Name:ERSKINE
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:918 QUEEN AVE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-4370
Mailing Address - Country:US
Mailing Address - Phone:509-654-4648
Mailing Address - Fax:
Practice Address - Street 1:2316 TERRACE HEIGHTS DR
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98901-1401
Practice Address - Country:US
Practice Address - Phone:509-654-4648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00019821225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist