Provider Demographics
NPI:1003779703
Name:BANG-KNUDSEN, ERIN (LMT)
Entity type:Individual
Prefix:MS
First Name:ERIN
Middle Name:
Last Name:BANG-KNUDSEN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 NW ADVANCE DR UNIT 544
Mailing Address - Street 2:
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-1043
Mailing Address - Country:US
Mailing Address - Phone:360-559-4448
Mailing Address - Fax:
Practice Address - Street 1:17791 FJORD DR NE STE 126
Practice Address - Street 2:
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-8430
Practice Address - Country:US
Practice Address - Phone:360-559-4448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-12-09
Last Update Date:2025-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA61519345225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist