Active NPI
Andrew Erickson, PHARMD, RPH
- Pharmacist
- Kelso, WA
National Provider Identifier
1770172629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH60595563
- Practice address
- 114 Pacific Ave S
Kelso, WA 98626-1616 - Phone
- (360) 425-3280
- Fax
- (360) 425-0625
- NPI assigned
- Jan 14, 2021
- Last updated
- Jan 14, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH60595563 | WA | Primary |
Addresses
Primary practice location
114 Pacific Ave S
Kelso, WA 98626-1616
Mailing address
114 Pacific Ave S
Kelso, WA 98626-1616
Phone (360) 425-3280
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)
- Not enrolled
- Credentials
- Doctor of Pharmacy, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH60595563 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610582400000",
"number": "1770172629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "114 PACIFIC AVE S",
"city": "KELSO",
"state": "WA",
"postal_code": "986261616",
"telephone_number": "360-425-3280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "114 PACIFIC AVE S",
"city": "KELSO",
"state": "WA",
"postal_code": "986261616",
"telephone_number": "360-425-3280",
"fax_number": "360-425-0625"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERICKSON",
"first_name": "ANDREW",
"name_prefix": "Dr.",
"credential": "PHARMD, RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-01-14",
"last_updated": "2021-01-14",
"certification_date": "2021-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH60595563",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kelso, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.