DR. RUSSELL C ERICKSON III (NPI# 1871591594) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871591594 |
| Entity Type | Individual |
| Full Name | DR. RUSSELL C ERICKSON III |
| Credential | DDS |
| Practice Address |
13530 Se 97th Ave Clackamas OR 97015-7691 |
| Practice Telephone | 5033531471 |
| Practice Fax Number | 5033531473 |
| Mailing Telephone | 5033531471 |
| Mailing Fax Number | 5033531473 |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
6120 | OR | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538512066 | Russell J Erickson | Physical Therapist | 150 W 100 N, Vernal, UT 84078-2036 | 2016-07-20 |
| 1376991059 | Russell Irving Carl Erickson Iv | Student in an Organized Health Care Education/Training Program | 25455 Barton Rd, Suite 206a, Loma Linda, CA 92354-3128 | 2016-06-02 |
| Street Address |
13530 SE 97TH AVE |
| City | CLACKAMAS |
| State | OR |
| Zip Code | 97015-7691 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497922041 | Russell Erickson Dds PC | Clinic/Center | 13530 Se 97th Ave, Clackamas, OR 97015-7691 | 2008-05-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184103517 | Laurel Perilli | Physical Therapist | 12550 Se 93rd Ave Ste 265, Clackamas, OR 97015 | 2018-08-07 |
| 1306324538 | Kristin Connor Messing | Physical Therapist | 4805 Ne Glisan St, Prov Hall 7e06, Portland, OR 97015 | 2018-07-31 |
| 1902317266 | Darcy Jones Hamrick | Counselor | 12901 Se 97th Ave., Suite 340, Clackamas, OR 97015 | 2017-10-13 |
| 1841723384 | Manon Lavoie | Chiropractor | 17105 Se Sunnyside Rd, Suite 148, Happy Valley, OR 97015 | 2017-04-11 |
| 1235670126 | Michael G Short | Pedorthist | 10117 Se Sunnyside Rd., Ste. H, Clackamas, OR 97015 | 2017-03-13 |
| 1487100756 | Michael Joseph Peizner | Pharmacist | 16300se Evelyn Street, Clackamas, OR 97015 | 2016-08-28 |
| 1316395619 | Jennifer Elaine Walkowski | Physical Therapist | 9100 Se Sunnyside Road, Clackamas, OR 97015 | 2016-05-26 |
| 1649635384 | Brookside Dental - Milwaukie, LLC | Dentist | 9225 Se Sunnyside Rd. Ste 1, Clackamas, OR 97015 | 2015-12-23 |
| 1801216130 | Robert D. Grew Dmd, Inc. | Dentist | 10163 Se Sunnyside Road, Suite 414, Clackamas, OR 97015 | 2014-04-25 |
| 1508205410 | Valerie P Tabalno | Massage Therapist | 15661 Se 82nd Dr, Clackamas, OR 97015 | 2013-06-25 |
| Find all providers in zip 97015 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649635384 | Brookside Dental - Milwaukie, LLC | Dentist | 9225 Se Sunnyside Rd. Ste 1, Clackamas, OR 97015 | 2015-12-23 |
| 1376800508 | Lance Don Bailey | Dentist | 10001 Se Sunnyside Rd Ste 250, Clackamas, OR 97015-9748 | 2012-04-12 |
| 1376751479 | Modern Family Dental, P.C. | Dentist | 12340 Se Sunnyside Rd, Clackamas, OR 97015-9320 | 2007-05-21 |
| 1215156625 | Katie Skovborg | Dentist | 12000 Se 82nd Ave Ste 1145, Clackamas, OR 97086 | 2007-04-24 |
| 1366564825 | Sylvia G Jimenez | Dentist | 11398 Se 82nd Ave, Ste 802, Clackamas, OR 97086-7637 | 2007-04-04 |
| 1205938016 | Joshua Robert Opperman | Dentist | 13023 Se 84th Ave Ste A, Clackamas, OR 97015-9798 | 2006-09-02 |
| 1932214806 | Kent D Lee | Dentist | 12016 Se Sunnyside Rd, Clackamas, OR 97015 | 2006-08-20 |
| 1184640062 | Harold Dean Geist | Dentist | 10209 Se Sunnyside Rd, Clackamas, OR 97015-9782 | 2006-07-14 |
| 1194766048 | Aziz John Karam | Dentist | 13652 Se Taralon Dr, Clackamas, OR 97015-3618 | 2006-06-10 |
| 1225020548 | Mark Noble Fred Reaksecker | Dentist | 15230 Se 82nd Dr, Clackamas, OR 97015-9606 | 2005-08-23 |
| Find all providers in CLACKAMAS | ||||
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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.