Individual
ERICA LYNN BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
2629 SW ANDOVER ST, SEATTLE, WA 98126-2591
(404) 271-1008
(866) 281-8349
Mailing address
4728 DELRIDGE WAY SW, SEATTLE, WA 98106-1329
(404) 271-1008
(866) 281-8349
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA60066922
WA
Other
Enumeration date
01/09/2009
Last updated
12/02/2009
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