1285790055 NPI number — ERIN SEIDMAN ALLAN MFT ASSOCIATE

Table of content: ERIN SEIDMAN ALLAN MFT ASSOCIATE (NPI 1285790055)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285790055 NPI number — ERIN SEIDMAN ALLAN MFT ASSOCIATE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALLAN
Provider First Name:
ERIN
Provider Middle Name:
SEIDMAN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MFT ASSOCIATE
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SEIDMAN
Provider Other First Name:
ERIN
Provider Other Middle Name:
BARBARA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MFT INTERN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1285790055
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/03/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3635 211TH PL NE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAMMAMISH
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98074-9345
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-213-0398
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1390 OAK ST STE 3
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EUGENE
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97401-3567
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-213-0398
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  49741 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com