Provider Demographics
NPI:1306186135
Name:SEVERSON-HOBSON, ERIN SUZANNE (RPH)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:SUZANNE
Last Name:SEVERSON-HOBSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:SUZANNE
Other - Last Name:HOBSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:612 N U ST
Mailing Address - Street 2:
Mailing Address - City:WASHOUGAL
Mailing Address - State:WA
Mailing Address - Zip Code:98671-8569
Mailing Address - Country:US
Mailing Address - Phone:360-606-5772
Mailing Address - Fax:
Practice Address - Street 1:3013 NW STEWART PKWY
Practice Address - Street 2:
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97471-1612
Practice Address - Country:US
Practice Address - Phone:541-957-9236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-14
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH0010106-P183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist