Individual
DR. MARK ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C., M.SC
Contact information
Practice address
625 NW 17TH AVE, PORTLAND, OR 97209-2209
(503) 924-6535
Mailing address
625 NW 17TH AVE, PORTLAND, OR 97209
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
5053
OR
Other
Enumeration date
05/04/2012
Last updated
05/04/2012
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