Individual
JASON SCOTT ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5848 S FASHION BLVD STE 110, SALT LAKE CITY, UT 84107-6175
(801) 314-4188
(801) 314-4015
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11111343-1206
UT
363A00000X
Physician Assistant
PA60942025
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265999056
—
WA
Enumeration date
02/27/2019
Last updated
03/15/2024
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