Individual
ERIC S. SECRIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1500 CONTINENTAL PL, MOUNT VERNON, WA 98273-4105
(360) 424-7041
(360) 424-2418
Mailing address
1401 S LAVENTURE RD, MOUNT VERNON, WA 98274-6033
(360) 424-7041
(360) 424-2418
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD61350532
WA
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
MD61350532
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2249973
—
WA
01
—
468405
WA L&I
WA
Enumeration date
03/29/2017
Last updated
08/16/2023
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