Individual
ERIKA ROOTVIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2330 EASTGATE ST STE 105, WALLA WALLA, WA 99362-1559
(509) 973-5788
Mailing address
2330 EASTGATE ST STE 105, WALLA WALLA, WA 99362-1559
(509) 973-5788
(509) 593-4366
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN60154855
WA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP60607176
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2049449
—
WA
Enumeration date
09/22/2015
Last updated
10/17/2021
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