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Individual
TRACY PETERSON ERIKSSON
Active
Individual
TRACY PETERSON ERIKSSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD00040728
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039572
LABOR & INDUSTRY
WA
01
—
8116ER
BLUE SHIELD
WA
05
—
8329310
—
WA
01
—
MD1251W
ALASKA MEDICAID
WA
01
—
US5051515
AETNA/USHC SPECIALIST
WA
Enumeration date
07/12/2006
Last updated
03/18/2015
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