Individual
ERIK JON DOMINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
1215 SW G. STREET, GRANTS PASS, OR 97526-2544
(541) 476-2373
(541) 476-1526
Mailing address
1215 SW G. STREET, GRANTS PASS, OR 97526-2544
(541) 476-2373
(541) 476-1526
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
163W00000X
Registered Nurse
201502991RN
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
202204953NP-PP
OR
Other
Enumeration date
09/24/2015
Last updated
05/02/2022
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