Basic Information
| Provider Information | |||||||||
| NPI: | 1528077930 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BUTLER | ||||||||
| FirstName: | ERIN | ||||||||
| MiddleName: | P | ||||||||
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| Credential: | PA C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1303 NE CUSHING DR | ||||||||
| Address2: | STE 100 | ||||||||
| City: | BEND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 977013887 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5413308226 | ||||||||
| FaxNumber: | 5413180373 | ||||||||
| Practice Location | |||||||||
| Address1: | 1253 NW CANAL BLVD | ||||||||
| Address2: | |||||||||
| City: | REDMOND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 977561334 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5415488131 | ||||||||
| FaxNumber: | 5415266608 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2006 | ||||||||
| LastUpdateDate: | 04/22/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/22/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 2026 | WI | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363AM0700X | PA01455 | OR | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.