DR. MARK ERICKSON (NPI# 1043579477) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043579477 |
| Entity Type | Individual |
| Full Name | DR. MARK ERICKSON |
| Credential | D.C., M.SC |
| Practice Address |
625 Nw 17th Ave Portland OR 97209-2209 |
| Mailing Address |
625 Nw 17th Ave Portland OR 97209 |
| Practice Telephone | 5039246535 |
| Enumeration Date | 2012-05-04 |
| Last Update Date | 2012-05-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111NS0005X |
Chiropractor Specialization: Sports Physician |
5053 | OR | Chiropractic Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225149198 | Mark Alan Erickson Sr. | Marriage & Family Therapist | 16248 Victor St, Victorville, CA 92395-3934 | 2006-08-31 |
| 1578579017 | Mark Arnold Erickson | Dentist | 612 13th St S, Virginia, MN 55792-3149 | 2006-08-01 |
| 1619937307 | Mark Lee Erickson | Dentist | 113 N Anthony Ave, Anthony, KS 67003-2007 | 2006-03-25 |
| 1336137157 | Mark F. Erickson | Dentist | 383 S Schmale Rd, Carol Stream, IL 60188-2756 | 2005-10-06 |
| 1295332286 | Mark S Erickson | Registered Nurse | 16045 1st Ave S, Burien, WA 98148-1401 | 2020-10-03 |
| 1285291088 | Mark William Erickson | Counselor | 11422 Miracle Hills Dr Ste 401, Omaha, NE 68154-4420 | 2019-05-28 |
| 1144587551 | Mark James Erickson | Dentist | 1836 South Ave, La Crosse, WI 54601 | 2012-04-23 |
| 1225325111 | Mark R Erickson | Physical Therapist | 161 W Wisconsin Ave, Pewaukee, WI 53072-3467 | 2011-06-30 |
| 1518193242 | Mark Andrew Erickson | Anesthesiology | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2009-06-09 |
| 1326135476 | Mark Erickson | Orthopaedic Surgery | 13123 E 16th Ave, Aurora, CO 80045-7106 | 2006-10-09 |
| Street Address |
625 NW 17TH AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97209-2209 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801906540 | Amy Brown | Physical Therapist | 625 Nw 17th Ave, Portland, OR 97209-2209 | 2006-08-30 |
| 1730591256 | Alexander Louis Pattinson | Chiropractor | 625 Nw 17th Ave, Portland, OR 97209-2209 | 2014-06-02 |
| 1407273162 | Paulina Thibodeaux | Massage Therapist | 625 Nw 17th Ave, Portland, OR 97209-2209 | 2014-03-19 |
| 1467707174 | Stewart Cameron | Massage Therapist | 625 Nw 17th Ave, Portland, OR 97209-2209 | 2012-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508476250 | Harrington Health Clinic | Nurse Practitioner | 310 Nw Glisan Street, Portland, OR 97209 | 2020-08-07 |
| 1619599636 | Rivers Way Training Clinic | Community/Behavioral Health | 2049 Nw Hoyt, Portland, OR 97209 | 2020-05-13 |
| 1518590538 | Julie Kay Igarta | Registered Nurse | 140 Northwest 14th Avenue, Portland, OR 97209 | 2020-02-18 |
| 1407492002 | Oregon Injection Clinic | Clinic/Center | 1500 Nw Lovejoy, 106, Portland, OR 97209 | 2019-11-19 |
| 1487202883 | Ann Tesora | Massage Therapist | 1320 Northwest 20th Avenue, Portland, OR 97209 | 2019-08-28 |
| 1972160455 | Vincent Martin | Massage Therapist | 210 Sw 17th Avenue, Portland, OR 97209 | 2019-05-21 |
| 1154896546 | Jennifer Marie Dodd | Social Worker | 1722 Nw Raleigh St Spc 412, Portland, OR 97209 | 2018-10-11 |
| 1922551910 | Ashley Crowell | Physician Assistant | 949 Nw Overton St Unit 306, Portland, OR 97209 | 2016-07-26 |
| 1326408394 | Jennifer Blain | Counselor | 324 Nw Davis, Portland, OR 97209 | 2016-03-03 |
| 1275993255 | Lauren Dodson | Licensed Practical Nurse | 324 Nw Davis St, Portland, OR 97209 | 2016-03-03 |
| Find all providers in zip 97209 | ||||
| Taxonomy Code | 111NS0005X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| Specialization | Sports Physician |
| A sports chiropractor is uniquely trained to provide care and treatment of injuries or illness resulting from sports and physical fitness activities. Doctors of Chiropractic with the Diplomate American Chiropractic Board of Sports Physicians (DACBSP) or the Certified Chiropractic Sports Physician (CCSP), sport specialty certifications from the American Chiropractic Board of Sports Physicians, have advanced training in the assessment, management and rehabilitation of sports related injuries. Extremity care, rehabilitation and soft tissue procedures are common skills utilized by these doctors. The specialty training covers a broad spectrum from the pediatric athlete to professional and Olympic athletes, and everything in between, using a variety of techniques and modalities. |
| Notes: Source: American Chiropractic Board of Sports Physicians, 2009 [7/1/2009: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952848764 | Cooper Jay Adams | Chiropractor | 6046 E Burnside St, Portland, OR 97215-1268 | 2017-01-31 |
| 1992172977 | Whittaker Wellness and Performance Center | Chiropractor | 1000 Sw Broadway, Suite 1210, Portland, OR 97205-3003 | 2015-08-26 |
| 1043571136 | Adam Goulet | Chiropractor | 1501 N Aisworth, Portland, OR 97217 | 2012-06-05 |
| 1427228220 | Seth David Watterson | Chiropractor | 4839 Ne Martin Luther King Jr Blvd Ste 207, Portland, OR 97211-3388 | 2008-03-07 |
| 1699822312 | Lynne Whalen | Chiropractor | 66 Pearl St Ste 320, Portland, ME 04101-4165 | 2007-01-04 |
| 1962576348 | Darren A Smith | Chiropractor | 4829 Ne Mlk Blvd, Portland, OR 97211-3491 | 2006-11-20 |
| 1750327318 | Dean Allen Clark | Chiropractor | 6105 S.w. Macadam Ave., Portland, OR 97239-3264 | 2006-06-21 |
| 1316987720 | John Charles Foland | Chiropractor | 2608 Ne Sandy Blvd, Portland, OR 97232-2342 | 2006-06-07 |
| 1801844568 | Karen B Kelsall | Chiropractor | 1615 Nw 23rd Ave, Suite 2, Portland, OR 97210-2557 | 2006-05-05 |
| 1295204634 | Kelsey Leigh Woodland | Chiropractor | 905 Se Ankeny St, Portland, OR 97214-1349 | 2018-11-15 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.