Provider Demographics
NPI:1992103519
Name:ERICKSON, LEAH YVONNE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LEAH
Middle Name:YVONNE
Last Name:ERICKSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9516 NE 73RD CIR
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-3920
Mailing Address - Country:US
Mailing Address - Phone:205-527-7545
Mailing Address - Fax:
Practice Address - Street 1:9516 NE 73RD CIR
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-3920
Practice Address - Country:US
Practice Address - Phone:205-527-7545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-13
Last Update Date:2014-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60517289183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist