Individual
DR. ERIK PENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
413 LILLY RD NE, OLYMPIA, WA 98506-5133
(360) 491-9480
Mailing address
PO BOX 5007, LACEY, WA 98509-5007
(800) 599-0166
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD00040914
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
159161
WA L & I
—
05
—
286778
—
OR
05
—
8312290
—
WA
01
—
8936736
WA CRIME VICTIMS
—
01
—
9117PE
REGENCE BS
—
01
—
A020
CHAMPUS
—
01
—
H58078
GROUP HEALTH
—
01
—
P00010657
RAILROAD
—
Enumeration date
06/21/2006
Last updated
11/27/2007
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