NPIMap

Organization Active NPI

Teresa a E Wills OD

Doing business as Teresa A Erickson OD

  • Optometrist
  • Milton, WA
National Provider Identifier
1235204587
Registry record updated Oct 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD00003106 Issued in WA
Legal business name
TERESA A E WILLS OD
Doing business as
Teresa A Erickson OD
Practice address
900 Meridian Ave E Ste 18
Milton, WA 98354-7003
Phone
(253) 927-5252
Fax
(253) 927-4270
NPI assigned
Nov 22, 2006
Last updated
Oct 22, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2007

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

Authorized official

Name
Teresa A Erickson, OD
Title
Owner
Phone
(253) 927-5252

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD00003106 WA Primary

Addresses

Primary practice location

900 Meridian Ave E Ste 18
Milton, WA 98354-7003

Mailing address

900 Meridian Ave E Ste 18
Milton, WA 98354-7003
Phone (253) 927-5252

Other identifiers 1

IdentifierTypeStateIssuer
2022119MedicaidWA

Other names 1

  • Teresa A Erickson OD Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193011200000",
    "number": "1235204587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 MERIDIAN AVE E STE 18",
            "city": "MILTON",
            "state": "WA",
            "postal_code": "983547003",
            "telephone_number": "253-927-5252",
            "fax_number": "253-927-4270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 MERIDIAN AVE E STE 18",
            "city": "MILTON",
            "state": "WA",
            "postal_code": "983547003",
            "telephone_number": "253-927-5252",
            "fax_number": "253-927-4270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERESA A E WILLS OD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2007-10-22",
        "status": "A",
        "authorized_official_last_name": "ERICKSON",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-927-5252",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00003106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2022119",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Teresa A Erickson OD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Milton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.