Provider Demographics
NPI:1548668882
Name:CLARE, ERICHA (ND, LAC)
Entity type:Individual
Prefix:DR
First Name:ERICHA
Middle Name:
Last Name:CLARE
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
Other - First Name:ERICHA
Other - Middle Name:BROOKS
Other - Last Name:CROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14335 NE ALTON CT
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97230-3525
Mailing Address - Country:US
Mailing Address - Phone:503-709-4237
Mailing Address - Fax:972-228-5443
Practice Address - Street 1:10365 SE SUNNYSIDE RD STE 210
Practice Address - Street 2:
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-5749
Practice Address - Country:US
Practice Address - Phone:503-887-7725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-19
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60545534175F00000X
OR1610175F00000X
OR198231171100000X
WAAC60545576171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist