1649089210 NPI number — ABIGAIL ZAPPONE ERICKSON LICSWA

Table of content: ABIGAIL ZAPPONE ERICKSON LICSWA (NPI 1649089210)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649089210 NPI number — ABIGAIL ZAPPONE ERICKSON LICSWA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ERICKSON
Provider First Name:
ABIGAIL
Provider Middle Name:
ZAPPONE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LICSWA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ZAPPONE
Provider Other First Name:
ABIGAIL
Provider Other Middle Name:
REBEKAH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LICSWA
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1649089210
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/07/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4305 E 15TH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPOKANE VALLEY
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
99212-0280
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-844-2763
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
235 E ROWAN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99207-1240
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-252-6446
Provider Business Practice Location Address Fax Number:
509-252-6490
Provider Enumeration Date:
01/07/2025

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: 1041C0700X , with the licence number:  61328907 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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