Individual provider Active NPI

Erik Nels Bjarke, M.D.

  • Diagnostic Radiology Physician
  • Puyallup, WA
National Provider Identifier
1487618757
Registry record updated Nov 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD00030368 Issued in WA
Practice address
222 15TH Ave SE
Puyallup, WA 98372-3754
Phone
(253) 841-4353
Fax
(253) 581-5698
NPI assigned
Apr 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD00030368 WA Primary
Diagnostic Radiology Physician 2085R0202X G63506 CA
Diagnostic Radiology Physician 2085R0202X MD17757 OR

Addresses

Primary practice location

222 15TH Ave SE
Puyallup, WA 98372-3754

Mailing address

7424 Bridgeport Way W
Suite 103
Lakewood, WA 98499-8120
Phone (253) 841-4353

Other identifiers 2

IdentifierTypeStateIssuer
43984OtherWAL&I
8145575MedicaidWA

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

State licenses

LicenseStateTypeSpecialty
G63506CAMDDiagnostic Radiology Physician
MD17757ORMDDiagnostic Radiology Physician
MD00030368WAMDDiagnostic Radiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478217600000",
    "number": "1487618757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7424 BRIDGEPORT WAY W",
            "address_2": "SUITE 103",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984998120",
            "telephone_number": "253-841-4353",
            "fax_number": "253-581-5698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 15TH AVE SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723754",
            "telephone_number": "253-841-4353",
            "fax_number": "253-581-5698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BJARKE",
        "first_name": "ERIK",
        "middle_name": "NELS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2016-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD00030368",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G63506",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OR",
            "license": "MD17757",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "43984",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8145575",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2016; 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.