Provider Demographics
NPI:1104237700
Name:ERNST, ALYCIA FAITH (MD)
Entity type:Individual
Prefix:DR
First Name:ALYCIA
Middle Name:FAITH
Last Name:ERNST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7340 SW HUNZIKER RD
Mailing Address - Street 2:STE 210
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-2304
Mailing Address - Country:US
Mailing Address - Phone:503-352-0036
Mailing Address - Fax:
Practice Address - Street 1:965 FEE RD
Practice Address - Street 2:ROOM A233
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48824-6569
Practice Address - Country:US
Practice Address - Phone:517-432-2993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-16
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORMD2063502084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry