Provider Demographics
NPI:1730337916
Name:CAMMON, ERIN ELIZABETH (LMP)
Entity type:Individual
Prefix:MS
First Name:ERIN
Middle Name:ELIZABETH
Last Name:CAMMON
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3279 70TH AVE E
Mailing Address - Street 2:APT. A102
Mailing Address - City:FIFE
Mailing Address - State:WA
Mailing Address - Zip Code:98424-3657
Mailing Address - Country:US
Mailing Address - Phone:253-353-5613
Mailing Address - Fax:
Practice Address - Street 1:1919 N PEARL ST
Practice Address - Street 2:SUITE A4
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98406-2461
Practice Address - Country:US
Practice Address - Phone:253-761-0930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-31
Last Update Date:2008-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA25206172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker