Ericksen, Michael Kent
Ericksen, Michael Kent is an individual health care provider with primary practice located at 9155 Sw Barnes Road , Portland OR 97225. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Ericksen, Michael Kent can be contacted via phone (503) 296-7800.Contact Information
Primary practice address
9155 Sw Barnes Road
Portland OR 97225
Phone: (503) 296-7800
Fax: (503) 291-1584
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD21148 | Oregon |
Profile Details
| NPI number | 1497773758 |
|---|---|
| LBN Legal business name | Ericksen, Michael Kent |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 17th, 2006 |
| Last updated | Jul 21st, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497773758 | NPPES |
| Oregon | MEDICAID | 151337 |
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