Provider Demographics
NPI:1093850539
Name:CASS, ERIKA MICHELLE (LMP)
Entity type:Individual
Prefix:MISS
First Name:ERIKA
Middle Name:MICHELLE
Last Name:CASS
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 17TH ST SE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-6367
Mailing Address - Country:US
Mailing Address - Phone:253-740-6613
Mailing Address - Fax:
Practice Address - Street 1:1920 69TH ST SE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98092-8783
Practice Address - Country:US
Practice Address - Phone:253-740-6613
Practice Address - Fax:253-863-2052
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00013517225700000X
WACL000619225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7327CAOtherREGENCE BLUE SHIELD
WA0144372OtherL AND I