Eriksen, Jacqueline M
Eriksen, Jacqueline M is an individual health care provider with primary practice located at 2435 Ne Cumulus Ave Ste A , Mcminnville OR 97128-8862. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Eriksen, Jacqueline M can be contacted via phone (503) 472-6161.Contact Information
Primary practice address
2435 Ne Cumulus Ave Ste A
Mcminnville OR 97128-8862
Phone: (503) 472-6161
Fax: (503) 434-6290
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MD22645 | Oregon |
Profile Details
| NPI number | 1588618458 |
|---|---|
| LBN Legal business name | Eriksen, Jacqueline M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 22nd, 2006 |
| Last updated | Jan 9th, 2013 - about 12 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 | 1588618458 | NPPES |
| Oregon | MEDICAID | 288246 |
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