Basic Information
Provider Information
NPI: 1447435185
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: EPSON
FirstName: ERIN
MiddleName: ELIZABETH
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3181 SW SAM JACKSON PARK RD
Address2:  
City: PORTLAND
State: OR
PostalCode: 972393011
CountryCode: US
TelephoneNumber: 5034949000
FaxNumber:  
Practice Location
Address1: 3181 SW SAM JACKSON PARK RD
Address2:  
City: PORTLAND
State: OR
PostalCode: 972393011
CountryCode: US
TelephoneNumber: 5034949000
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/31/2007
LastUpdateDate: 02/24/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XLL16948ORN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RI0200XMD29149ORY Allopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease

No ID Information.


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