Individual
ERIKA BUCKLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
930 SW HALL ST., PORTLAND, OR 97201-9720
(503) 725-4073
Mailing address
14829 SW MILLIKAN WAY APT 1015, BEAVERTON, OR 97003-5495
(925) 876-7420
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
AT-AT-10171402
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AT-AT-10171402
OREGON HEALTH LICENSING
OR
Enumeration date
01/03/2018
Last updated
01/03/2018
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