Individual
MRS. MARIE ELIZABETH ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
207 E CHERRY ST, BUTLER HOUSE, WALLA WALLA, WA 99362
(509) 520-2283
Mailing address
2304 GARRISON ST, WALLA WALLA, WA 99362
(509) 520-2283
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW00004310
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26595
GROUP HEALTH PIN NUMBER
—
01
—
6020557530010001
UBI NUMBER
WA
01
—
R11636
MEDICARE ID NUMBER
—
Enumeration date
07/16/2007
Last updated
07/16/2007
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