Provider Demographics
NPI:1699982587
Name:KOERSELMAN, ERINN ELIZABETH (MA)
Entity type:Individual
Prefix:
First Name:ERINN
Middle Name:ELIZABETH
Last Name:KOERSELMAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:734 N 201ST ST
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-3106
Mailing Address - Country:US
Mailing Address - Phone:206-579-7544
Mailing Address - Fax:
Practice Address - Street 1:10740 MERIDIAN AVE N STE 104
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-9010
Practice Address - Country:US
Practice Address - Phone:206-579-7544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00050574101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health