Basic Information
| Provider Information | |||||||||
| NPI: | 1205592060 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ERRIU | ||||||||
| FirstName: | LORELLA | ||||||||
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| Credential: | HIS WA LICENSE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2519 E MILL PLAIN BLVD APT 108 | ||||||||
| Address2: | |||||||||
| City: | VANCOUVER | ||||||||
| State: | WA | ||||||||
| PostalCode: | 986614360 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5092028005 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11516 SE MILL PLAIN BLVD STE 2J | ||||||||
| Address2: | |||||||||
| City: | VANCOUVER | ||||||||
| State: | WA | ||||||||
| PostalCode: | 986845082 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3608828027 | ||||||||
| FaxNumber: | 3608828030 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/16/2021 | ||||||||
| LastUpdateDate: | 09/12/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/11/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237700000X | N | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist | 237700000X | HA61183998 | WA | Y | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |
No ID Information.