Healthcare Provider Details

I. General information

NPI: 1932179496
Provider Name (Legal Business Name): JAMES KELLY HYCHE JR. PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

US NAVAL HOSPITAL OKINAWA PSC 482
FPO AP
96362
US

IV. Provider business mailing address

PSC 80 BOX 17265
APO AP
96367-0073
US

V. Phone/Fax

Practice location:
  • Phone: 011813116437555
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2428
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: