Provider Demographics
NPI:1487125407
Name:TATE, ERIN DAVID
Entity type:Individual
Prefix:MR
First Name:ERIN
Middle Name:DAVID
Last Name:TATE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5444 DELRIDGE WAY SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98106-1534
Mailing Address - Country:US
Mailing Address - Phone:206-937-1714
Mailing Address - Fax:206-937-1709
Practice Address - Street 1:5444 DELRIDGE WAY SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98106-1534
Practice Address - Country:US
Practice Address - Phone:206-937-1714
Practice Address - Fax:206-937-1709
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60901004171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator