Provider Demographics
NPI:1447440904
Name:ERIKSSON, AMBER CHRISTINA (MS, PMHNP)
Entity type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:CHRISTINA
Last Name:ERIKSSON
Suffix:
Gender:F
Credentials:MS, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 82819
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97282-0819
Mailing Address - Country:US
Mailing Address - Phone:503-439-9531
Mailing Address - Fax:503-531-3841
Practice Address - Street 1:9040 JACKSON AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-9327
Practice Address - Country:US
Practice Address - Phone:253-968-4851
Practice Address - Fax:253-968-3731
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200750089NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR231994Medicaid