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Individual

DR. MICHAEL SCOTT EICKERMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
14841 179TH AVE SE STE 140, MONROE, WA 98272-1127
(360) 794-1415
Mailing address
19030 LENTON PL SE # 608, MONROE, WA 98272-1353
(360) 794-1415

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
30108
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1103571
WA
Enumeration date
08/09/2006
Last updated
07/08/2007
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