Active NPI
Laurie Ann Erickson, T.H.W & M.A.I.S.
- Peer Specialist
- Eugene, OR
National Provider Identifier
1063971216
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- Practice address
- CDRC 901 E 18TH Ave
Eugene, OR 97402 - Phone
- (541) 744-6551
- Fax
- (503) 346-6918
- NPI assigned
- Mar 18, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | Primary |
Addresses
Primary practice location
CDRC 901 E 18TH Ave
Eugene, OR 97402
Mailing address
3181 SW Sam Jackson Park Rd. Ohsu-CDRC
Portland, OR 97239
Phone (503) 494-8060
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3697107 | Other | OR | OREGON DRIVERS LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660089600000",
"number": "1063971216",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3181 SW SAM JACKSON PARK RD. OHSU-CDRC",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97239",
"telephone_number": "503-494-8060",
"fax_number": "503-494-5990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CDRC 901 E 18TH AVE",
"city": "EUGENE",
"state": "OR",
"postal_code": "97402",
"telephone_number": "541-744-6551",
"fax_number": "503-346-6918"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERICKSON",
"first_name": "LAURIE",
"middle_name": "ANN",
"credential": "T.H.W & M.A.I.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-18",
"last_updated": "2022-08-10",
"certification_date": "2022-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OREGON DRIVERS LICENSE",
"identifier": "3697107",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eugene, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.