Individual
MR. TIMOTHY A ERICSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
1475 MT HOOD AVE., WOODBURN, OR 97071
(503) 982-2174
(503) 982-4599
Mailing address
PO BOX 278, WOODBURN, OR 97071-0278
(971) 983-5260
(971) 983-5326
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
201394165NP-PP
OR
363L00000X
Nurse Practitioner
NP 20561
CA
Other
Enumeration date
05/16/2011
Last updated
12/02/2017
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