Individual
DR. JENNIFER ELAINE ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
3330 4TH ST, LEWISTON, ID 83501-4405
(208) 746-2025
(208) 746-2025
Mailing address
PO BOX 1506, CHEHALIS, WA 98532-0409
(360) 242-3008
(360) 807-7987
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
OD60644428
WA
152W00000X
Optometrist
Primary
ODP-100359
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497134399
—
ID
05
—
2064914
—
WA
Enumeration date
05/25/2015
Last updated
08/01/2025
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