Basic Information
| Provider Information | |||||||||
| NPI: | 1467781203 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | STARTIN | ||||||||
| FirstName: | ERIN | ||||||||
| MiddleName: | NICOLE | ||||||||
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| Credential: | ATC/L, LMP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 301 DAILEY RD | ||||||||
| Address2: | |||||||||
| City: | COLFAX | ||||||||
| State: | WA | ||||||||
| PostalCode: | 991118587 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5093973435 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1200 W FAIRVIEW ST | ||||||||
| Address2: | |||||||||
| City: | COLFAX | ||||||||
| State: | WA | ||||||||
| PostalCode: | 991119552 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5093973435 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/07/2009 | ||||||||
| LastUpdateDate: | 11/10/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225700000X | MA 60050030 | WA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Massage Therapist | 2255A2300X | A1 60130015 | WA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Specialist/Technologist | Athletic Trainer |
No ID Information.