Individual provider Active NPI

Jaslyn Esther Erickson, MD

  • Pediatrics Physician
  • Walla Walla, WA
National Provider Identifier
1174273155
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
61666802 Issued in WA
Practice address
55 W Tietan St BLDG a
Walla Walla, WA 99362-4445
Phone
(509) 525-3720
NPI assigned
Mar 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 61666802 WA Primary

Addresses

Primary practice location

55 W Tietan St BLDG a
Walla Walla, WA 99362-4445

Mailing address

55 W Tietan St BLDG a
Walla Walla, WA 99362-4498
Phone (509) 525-3720

Other practice location 1

1 Baylor Plz # Bcm320
Houston, TX 77030-3411
Phone (832) 825-6497

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250730004512 WA Practitioner - Pediatric Medicine 3971010133 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61666802WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Walla Walla Clinic, Inc. Current Accepting new patients
Walla Walla Clinic, Inc. CurrentSince Aug 1, 2025 Accepting new patients
Privia Medical Group Washington, PLLC CurrentSince Aug 1, 2025 Accepting new patients
Providence Health & Services - Washington Past Accepting new patients
Privia Medical Group Washington, PLLC PastSince May 11, 2025 Accepting new patients

Locations

55 W Tietan St
Walla Walla, WA 99362
Phone (509) 525-3720

55 W Tietan St
Bldg A
Walla Walla, WA 99362
Phone (509) 525-3720

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/28594/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1648080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1174273155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 W TIETAN ST BLDG A",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993624498",
            "telephone_number": "509-525-3720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 W TIETAN ST BLDG A",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993624445",
            "telephone_number": "509-525-3720"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Baylor Plz # Bcm320",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770303411",
            "country_code": "US",
            "telephone_number": "832-825-6497",
            "fax_number": "832-825-6497",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "JASLYN",
        "middle_name": "ESTHER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-24",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "61666802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walla Walla, WA

Sources for this page

Verify at the official NPI Registry.