Basic Information
| Provider Information | |||||||||
| NPI: | 1043668940 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STEINER | ||||||||
| FirstName: | ERIN | ||||||||
| MiddleName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 3896 BEVERLY AVE NE STE 40 | ||||||||
| Address2: | |||||||||
| City: | SALEM | ||||||||
| State: | OR | ||||||||
| PostalCode: | 973051374 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5035880076 | ||||||||
| FaxNumber: | 5035880531 | ||||||||
| Practice Location | |||||||||
| Address1: | 3896 BEVERLY AVE NE | ||||||||
| Address2: | BLDG J, SUITE 40 | ||||||||
| City: | SALEM | ||||||||
| State: | OR | ||||||||
| PostalCode: | 973051374 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5035880076 | ||||||||
| FaxNumber: | 5035880531 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2016 | ||||||||
| LastUpdateDate: | 03/24/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/24/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 201604220RN | OR | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LF0000X | AP60641870 | WA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | 201604221 | OR | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363L00000X | 201604221NP-PP | OR | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 500714035 | 05 | OR | MEDICAID | R189678 | 01 | OR | MEDICARE | OTHER |