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Individual

LAURIE ANN ERICKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
T.H.W & M.A.I.S.

Contact information

Practice address
CDRC 901 E 18TH AVE, EUGENE, OR 97402
(541) 744-6551
(503) 346-6918
Mailing address
3181 SW SAM JACKSON PARK RD. OHSU-CDRC, PORTLAND, OR 97239
(503) 494-8060
(503) 494-5990

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3697107
OREGON DRIVERS LICENSE
OR
Enumeration date
03/18/2019
Last updated
08/10/2022
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