DR. JAY C. ERICKSON (NPI# 1114990587) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114990587 |
| Entity Type | Individual |
| Full Name | DR. JAY C. ERICKSON |
| Credential | M.D. |
| Practice Address |
1608 S J St Fl 5 Tacoma WA 98405-4930 |
| Practice Telephone | 2532747505 |
| Practice Fax Number | 2532747947 |
| Mailing Telephone | 2532747505 |
| Mailing Fax Number | 2532747947 |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2020-08-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
MD60823049 | WA | Allopathic & Osteopathic Physicians |
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
01052312A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | MEDICAL LICENSE | 01052312A | 01 |
| WA | DEA NUMBER | BE8985193 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| Neurology Service, Madiagn Army Medical Center, Tacoma, WA 984310001 | 2539681440 | 2539680443 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447246152 | Jay Erickson | Family Medicine | 1458 4th St Mcagcc/ Magtftc, 7th Marine Regimental Aid Station, Twentynine Palms, CA 92278 | 2005-09-27 |
| 1558363077 | Jay Randall Erickson | Obstetrics & Gynecology | 1029 Edgefield St, Greenwood, SC 29646-3205 | 2005-08-15 |
| 1033556105 | Jay M Erickson | Dentist | 1509 Emerald Pkwy Ste 105, College Station, TX 77845-5502 | 2013-05-30 |
| 1255517702 | Jay Emory Erickson | Counselor | 900 S Broadway, Suite 100, Denver, CO 80209-4198 | 2008-01-15 |
| 1083753032 | Jay Merwin Erickson | Chiropractor | 455 N Milledge Ave, Athens, GA 30601-3807 | 2007-02-06 |
| 1932283231 | Jay Roger Erickson | Internal Medicine | 1717 N E St, Suite 439, Pensacola, FL 32501-6339 | 2006-10-24 |
| 1992896864 | Jay T Erickson | Nurse Anesthetist, Certified Registered | 300 N 7th St, Bismarck, ND 58501-4439 | 2006-09-27 |
| 1235237660 | Jay S Erickson | Family Medicine | 1111 Baker Ave, Glacier Medical Associates, Whitefish, MT 59937-2901 | 2006-09-20 |
| Street Address |
1608 S J ST FL 5 |
| City | TACOMA |
| State | WA |
| Zip Code | 98405-4930 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417434572 | Joshua Snavely | Registered Nurse | 1608 S J St Fl 5, Tacoma, WA 98405-4930 | 2018-07-22 |
| 1144733668 | Caoilin Hoctor | Neurological Surgery | 1608 S J St Fl 5, Tacoma, WA 98405-4930 | 2017-11-06 |
| 1316330756 | Yelena V Golub | Physician Assistant | 1608 S J St Fl 5, Tacoma, WA 98405-4930 | 2015-03-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609486026 | Joanna Christine Hope | Physician Assistant | 2502 S Union Avenue, Tacoma, WA 98405 | 2020-08-01 |
| 1467077891 | Richard Jimenez | Student in an Organized Health Care Education/Training Program | 1202 M.l.k. Jr Way Suite #310, Tacoma, WA 98405 | 2020-06-11 |
| 1669008785 | Mariana Sanchez Corona | Behavior Technician | 1901 S Union Ave Allenmore Building B, Tacoma, WA 98405 | 2020-03-20 |
| 1811534845 | Jasmine Gregory | Social Worker | 311 Martin Luther King Jr. Way, Ms:315-c2-php, Tacoma, WA 98405 | 2019-12-10 |
| 1548807506 | Holly Rebecca Brezynski | Student in an Organized Health Care Education/Training Program | Fresenius Kindney Care - Home Therapies Department, 1717 South J Street, Tacoma, WA 98405 | 2019-12-09 |
| 1972064392 | Logan Brau | Student in an Organized Health Care Education/Training Program | 1202 M.l.k. Jr Way, Tacoma, WA 98405 | 2019-03-28 |
| 1629532536 | Preferred Orthotic and Prosthetic Services Inc | Prosthetic/Orthotic Supplier | 1708 Yakima Ave Ste 60, Tacoma, WA 98405 | 2019-01-24 |
| 1669945911 | Heidi Weakley | Counselor | 1001 S Yakima Ave, Suite 5, Tacoma, WA 98405 | 2019-01-09 |
| 1972074011 | Taviance Benet Laster | Behavior Technician | 1416 S 9th St, Tacoma, WA 98405 | 2018-12-16 |
| 1336618040 | Bailey Bangerter | Physician Assistant | 1901 South Union, A-233, Tacoma, WA 98405 | 2018-11-26 |
| Find all providers in zip 98405 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275954646 | George Delyanis | Psychiatry & Neurology | 1220 Ventura Dr, Tacoma, WA 98465-1240 | 2014-01-02 |
| 1346403383 | Stacy L. Donlon | Psychiatry & Neurology | 915 6th Ave Ste 100, Tacoma, WA 98405-4682 | 2008-07-09 |
| 1316114184 | Edward Tay | Psychiatry & Neurology | 209 Martin Luther King Jr. Way, Group Health Cooperative, Tacoma Specialty Center Neuro, Tacoma, WA 98405 | 2008-05-12 |
| 1023297769 | Cristina Cruz-crespo | Psychiatry & Neurology | Madigan Army Medical Center-neurology, 9040a Fitzsimmons Drive, Tacoma, WA 98431-0001 | 2007-10-30 |
| 1831177922 | Keyi Yang | Psychiatry & Neurology | 1708 So. Yakima Ave, Ste 118, Tacoma, WA 98405-5307 | 2006-01-09 |
| 1275530859 | John Robert Huddlestone | Psychiatry & Neurology | 915 6th Ave, Ste 200, Tacoma, WA 98405-4682 | 2005-06-28 |
| 1205290368 | Keith Andrew Groshans | Psychiatry & Neurology | 9040 Jackson Ave, Tacoma, WA 98431-0004 | 2016-04-05 |
| 1568889731 | Derek Ting Yu | Psychiatry & Neurology | 209 Martin Luther King Jr Way, Tacoma, WA 98405-4265 | 2014-03-25 |
| 1205271442 | James Joseph Gutierrez | Psychiatry & Neurology | 209 Martin Luther King Jr Way, Tacoma, WA 98405 | 2013-05-01 |
| 1407290307 | Valentin Laticevschi | Psychiatry & Neurology | 315 Martin Luther King Jr Way, Tacoma, WA 98405 | 2013-04-22 |
| Find all providers in TACOMA | ||||
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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.