Active NPI
David L. Erickson, MD
- Internal Medicine Physician
- Everett, WA
National Provider Identifier
1114028180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD00018476
- Practice address
- 12800 Bothell Everett Hwy
Suite 120
Everett, WA 98208-6642 - Phone
- (425) 316-5150
- Fax
- (425) 316-5153
- NPI assigned
- Sep 25, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD00018476 | WA | Primary |
Addresses
Primary practice location
12800 Bothell Everett Hwy
Suite 120
Everett, WA 98208-6642
Mailing address
PO Box 3360
Portland, OR 97208-3360
Phone (425) 317-0279
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1678705 | Medicaid | WA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389312000000",
"number": "1114028180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3360",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972083360",
"telephone_number": "425-317-0279",
"fax_number": "425-317-0291"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12800 BOTHELL EVERETT HWY",
"address_2": "SUITE 120",
"city": "EVERETT",
"state": "WA",
"postal_code": "982086642",
"telephone_number": "425-316-5150",
"fax_number": "425-316-5153"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERICKSON",
"first_name": "DAVID",
"middle_name": "L.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-25",
"last_updated": "2014-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WA",
"license": "MD00018476",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1678705",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.