Provider Demographics
NPI:1285297770
Name:EIERDAM, ASHLEY CARICIA (HUSS)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:CARICIA
Last Name:EIERDAM
Suffix:
Gender:F
Credentials:HUSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3814 E 34TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-5925
Mailing Address - Country:US
Mailing Address - Phone:509-992-7099
Mailing Address - Fax:
Practice Address - Street 1:3814 E 34TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-5925
Practice Address - Country:US
Practice Address - Phone:509-992-7099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-19
Last Update Date:2019-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist