Individual
ERIN BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20105 SW WALQUIN CT, ALOHA, OR 97078-3704
(503) 575-5814
Mailing address
20105 SW WALQUIN CT, ALOHA, OR 97078-3704
(503) 575-5814
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
06/06/2016
Last updated
06/06/2016
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