NPIMap

Individual provider Active NPI

Erin Ashley Dautremont, DO

  • Family Medicine Physician
  • Puyallup, WA
National Provider Identifier
1154986065
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP61252300 Issued in WA
Practice address
2930 S Meridian Ste 200
Puyallup, WA 98373-1654
Phone
(253) 445-7600
Fax
(253) 864-5999
NPI assigned
May 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OP61252300 WA Primary

Addresses

Primary practice location

2930 S Meridian Ste 200
Puyallup, WA 98373-1654

Mailing address

2930 S Meridian Ste 200
Puyallup, WA 98373-1654
Phone (253) 445-7600

Other identifiers 1

IdentifierTypeStateIssuer
2211703MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address edautremont751801@fhsce.catholichealth.net Direct Franciscan Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220825003724 WA Practitioner - Family Practice 2668889965 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Touro Un Col of Osteopathic Medicine, Henderson, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

2930 S Meridian
Suite 200
Puyallup, WA 98373-1654
Phone (253) 864-5900

Hospital & facility affiliations

  • CHI Franciscan Health at Home Home health agency, University Place, WA, CCN 507124
  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108
  • St Francis Community Hospital Hospital, Federal Way, WA, CCN 500141
  • St Clare Hospital Hospital, Lakewood, WA, CCN 500021

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OP61252300WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Family Medicine CurrentSince Aug 1, 2022 Accepting new patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group CurrentSince Aug 1, 2022 Accepting new patients
Franciscan Medical Group Family Medicine Past Accepting new patients

Locations

34503 9th Ave S
Ste 130
Federal Way, WA 98003
Phone (253) 835-5340

12005 Meridian E
#101
Puyallup, WA 98373
Phone (253) 215-1095

2930 S Meridian
Ste 200
Puyallup, WA 98373
Phone (253) 445-7600

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1557100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1154986065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2930 S MERIDIAN STE 200",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983731654",
            "telephone_number": "253-445-7600",
            "fax_number": "253-864-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2930 S MERIDIAN STE 200",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983731654",
            "telephone_number": "253-445-7600",
            "fax_number": "253-864-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUTREMONT",
        "first_name": "ERIN",
        "middle_name": "ASHLEY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-06",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP61252300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2211703",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "edautremont751801@fhsce.catholichealth.net",
            "affiliation": "Y",
            "affiliationName": "Franciscan Medical Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2930 S Meridian Ste 200",
            "city": "Puyallup",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983731654",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.