Provider Demographics
NPI:1306161153
Name:ERBE, JACQUELINE (LMP)
Entity type:Individual
Prefix:MISS
First Name:JACQUELINE
Middle Name:
Last Name:ERBE
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 1:1752 NW MARKET ST # 637
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-5224
Mailing Address - Country:US
Mailing Address - Phone:206-719-8090
Mailing Address - Fax:
Practice Address - Street 1:1752 NW MARKET ST # 637
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-5224
Practice Address - Country:US
Practice Address - Phone:206-719-8090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-05
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60130329174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist