Basic Information
| Provider Information | |||||||||
| NPI: | 1073691473 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OROURKE | ||||||||
| FirstName: | ERIN | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | DPM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7320 216TH ST SW STE 320 | ||||||||
| Address2: | |||||||||
| City: | EDMONDS | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980268006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4256733900 | ||||||||
| FaxNumber: | 4256733910 | ||||||||
| Practice Location | |||||||||
| Address1: | 7320 216TH ST SW STE 320B | ||||||||
| Address2: | |||||||||
| City: | EDMONDS | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980268006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4257756996 | ||||||||
| FaxNumber: | 4256708905 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/02/2006 | ||||||||
| LastUpdateDate: | 06/21/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213ES0131X | PO00000496 | WA | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot Surgery | 213E00000X | PO00000496 | WA | N | Podiatric Medicine & Surgery Service Providers | Podiatrist |
ID Information
| ID | Type | State | Issuer | Description | OR5426 | 01 | WA | REGENCE RIDER | OTHER | 1104629 | 05 | WA | MEDICAID | 480031927 | 01 | WA | MEDICARE RR | OTHER | 1001872 | 05 | WA | MEDICAID |