Gary Duane Ericson, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD20450 Issued in OR

Practice address

800 SW 13TH Ave
Portland, OR 97205

Phone

(503) 221-0161

Fax

(503) 221-4451

NPI assigned

Sep 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324598400000",
    "number": "1992897177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 GEORGE JACKSON RD",
            "city": "MAUPIN",
            "state": "OR",
            "postal_code": "970379208",
            "telephone_number": "541-395-2911",
            "fax_number": "541-395-2912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SW 13TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97205",
            "telephone_number": "503-221-0161",
            "fax_number": "503-221-4451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICSON",
        "first_name": "GARY",
        "middle_name": "DUANE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2011-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD20450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269835",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Molly Janezich Erickson, LAC
• Neil Erickson
• Shelby Rae Erickson
• Spencer Emil Erickson, RN, NP
• Victoria Miller Erickson, MD
• Erik K Szeto DO PC
• Jessica M Eriksen, CADC I
• Carl O Eriksson, M.D.
• Erin a Palmer
• Erin Durst Psychotherapy LLC

• Internal Medicine Physician in Portland, OR
• Providers in Portland, OR by specialty
• Internal Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2011; 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.