Provider Demographics
NPI:1699974873
Name:DEROCHE, ERIK JAMES (MS, DC, CSCS)
Entity type:Individual
Prefix:DR
First Name:ERIK
Middle Name:JAMES
Last Name:DEROCHE
Suffix:
Gender:M
Credentials:MS, DC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3410 WOBURN ST STE 202
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-5621
Mailing Address - Country:US
Mailing Address - Phone:360-752-0061
Mailing Address - Fax:
Practice Address - Street 1:3410 WOBURN ST STE 202
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-5621
Practice Address - Country:US
Practice Address - Phone:360-752-0061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-17
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH34787111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WACH34787OtherWASHINGTON STATE LICENSE