Healthcare Provider Details

I. General information

NPI: 1689679144
Provider Name (Legal Business Name): ALAN WYCHE BICKEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2005
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8614 E MILL PLAIN BLVD STE 201
VANCOUVER WA
98664-2058
US

IV. Provider business mailing address

PO BOX 560825
DENVER CO
80256-0825
US

V. Phone/Fax

Practice location:
  • Phone: 360-729-8580
  • Fax: 360-729-8599
Mailing address:
  • Phone: 719-595-7580
  • Fax: 719-545-0176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number32469
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberDR.0032469
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number4301512752
License Number StateMI
# 4
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberMD61509301
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: