Individual
DR. CARL MICHAEL ERICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
6542 SE LAKE RD STE 202, MILWAUKIE, OR 97222-2245
(503) 233-5273
(855) 492-8902
Mailing address
6542 SE LAKE RD STE 202, MILWAUKIE, OR 97222-2245
(503) 233-5273
(855) 492-8902
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
DO12690
OR
207Q00000X
Family Medicine Physician
Primary
DO12690
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
120000019
MEDICARE RAILROAD
OR
05
—
226639
—
OR
Enumeration date
08/24/2005
Last updated
06/15/2021
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