Provider Demographics
NPI:1730584558
Name:DOTY, ERIKA
Entity type:Individual
Prefix:DR
First Name:ERIKA
Middle Name:
Last Name:DOTY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 B AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97034-2960
Mailing Address - Country:US
Mailing Address - Phone:503-387-6116
Mailing Address - Fax:503-387-3941
Practice Address - Street 1:630 B AVE STE 2
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97034-2960
Practice Address - Country:US
Practice Address - Phone:503-387-6116
Practice Address - Fax:503-387-3941
Is Sole Proprietor?:No
Enumeration Date:2014-10-23
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2471103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent