Healthcare Provider Details

I. General information

NPI: 1902727217
Provider Name (Legal Business Name): HANNAH HICKS CRM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 E 11TH AVE
EUGENE OR
97401-3246
US

IV. Provider business mailing address

341 E 12TH AVE
EUGENE OR
97401-3275
US

V. Phone/Fax

Practice location:
  • Phone: 541-683-1641
  • Fax: 541-681-3294
Mailing address:
  • Phone: 541-729-2277
  • Fax: 541-632-8301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number26-CRM-5331
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: