NPIMap

Organization Active NPI

Juliette Erickson MD PS

Doing business as Juliette K Erickson MD

  • Family Medicine Physician
  • Aberdeen, WA
National Provider Identifier
1710026448
Registry record updated Dec 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00040826 Issued in WA
Legal business name
JULIETTE ERICKSON MD PS
Doing business as
Juliette K Erickson MD
Practice address
1020 Anderson Dr
Suite 203
Aberdeen, WA 98520-1055
Phone
(360) 533-6063
Fax
(360) 533-2204
NPI assigned
Feb 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2007

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

Authorized official

Name
Jan Dahl
Title
Office Manager
Phone
(360) 533-6063

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X MD00040826 WA Primary

Addresses

Primary practice location

1020 Anderson Dr
Suite 203
Aberdeen, WA 98520-1055

Mailing address

1020 Anderson Dr
Suite 203
Aberdeen, WA 98520-1055
Phone (360) 533-6063

Other identifiers 1

IdentifierTypeStateIssuer
1115591MedicaidWA

Other names 1

  • Juliette K Erickson MD Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197590400000",
    "number": "1710026448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 ANDERSON DR",
            "address_2": "SUITE 203",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985201055",
            "telephone_number": "360-533-6063",
            "fax_number": "360-533-2204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 ANDERSON DR",
            "address_2": "SUITE 203",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985201055",
            "telephone_number": "360-533-6063",
            "fax_number": "360-533-2204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JULIETTE ERICKSON MD PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-12-14",
        "status": "A",
        "authorized_official_last_name": "DAHL",
        "authorized_official_first_name": "JAN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "360-533-6063"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00040826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1115591",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Juliette K Erickson MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aberdeen, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 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.