| Richard L. Dickson | |
|
481 West E St Forks WA 98331 | |
| (360) 374-6642 | |
| (360) 374-5335 |
| Full Name | Richard L. Dickson |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 481 West E St, Forks, Washington |
| Authorized Official Name and Position | Richard L Dickson (OWNER PHYSICIAN) |
| Authorized Official Contact | 3603746642 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Richard L. Dickson Po Box 1918 Forks WA 98331 Ph: (360) 374-6642 | Richard L. Dickson 481 West E St Forks WA 98331 Ph: (360) 374-6642 |
| NPI Number | 1720276207 |
|---|---|
| Provider Enumeration Date | 10/09/2007 |
| Last Update Date | 02/13/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720276207 | NPI | - | NPPES |
| 7079999 | Medicaid | WA | |
| 59570 | Other | WA | DEPT OF L I |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (Washington) | Primary |
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