Basic Information
Provider Information
NPI: 1215136262
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MARTIN-WEEKS
FirstName: ERIN
MiddleName: LYNN
NamePrefix:  
NameSuffix:  
Credential: D.O., MPH
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 425 E 7TH ST
Address2:  
City: THE DALLES
State: OR
PostalCode: 970582607
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 425 E 7TH ST
Address2:  
City: THE DALLES
State: OR
PostalCode: 970582607
CountryCode: US
TelephoneNumber: 5412964610
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/11/2007
LastUpdateDate: 07/11/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XDO27597ORY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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