Individual provider Active NPI

Notie Andrea Iyen Erhahon, M.D

  • Pediatrics Physician
  • Mount Vernon, WA
National Provider Identifier
1538457007
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD60410165 Issued in WA
Practice address
125 N 18TH St Ste a
Mount Vernon, WA 98273-3902
Phone
(605) 885-5703
Fax
(360) 588-5562
NPI assigned
Jul 18, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 125059151 IL
Pediatrics Physician 208000000X MD60410165 WA Primary

Addresses

Primary practice location

125 N 18TH St Ste a
Mount Vernon, WA 98273-3902

Mailing address

PO Box 34703
Seattle, WA 98124-1703

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
I20140829000018 WA Practitioner - Pediatric Medicine 7012135247 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125059151ILMDPediatrics Physician
MD60410165WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sea Mar Community Health Centers CurrentSince Jun 28, 2014 Accepting new patients
Sea Mar Community Health Centers CurrentSince Jun 28, 2014 Accepting new patients
Sea Mar Community Health Centers Current Accepting new patients
Sea-Mar Community Health Center Past Accepting new patients

Locations

1400 N Laventure Rd
Mount Vernon, WA 98273
Phone (360) 428-4075

125 N 18th St
Ste A
Mount Vernon, WA 98273
Phone (360) 428-3068

Interoperability endpoints

  • Direct secure messaging: nerhahon450362@direct.multicare.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1310947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1538457007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34703",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 N 18TH ST STE A",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982733902",
            "telephone_number": "605-885-5703",
            "fax_number": "360-588-5562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERHAHON",
        "first_name": "NOTIE",
        "middle_name": "ANDREA IYEN",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-18",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125059151",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD60410165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

Verify at the official NPI Registry.