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General NPI Number Information
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NPI Number | 1063616464
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Entity Type | Individual
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Provider Name | RAYMOND H HICKS MD
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Gender | Male
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Dates
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Enumeration Date | 06/12/2007
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 1 BOONE RD
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City | BREMERTON
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State | WA
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Zip | 98312-1894
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Country | US
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Telephone | 604-766-0343
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Fax |
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Provider Business Mailing Address
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Address Line | 1 BOONE RD RM 3604
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City | BREMERTON
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State | WA
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Zip | 98312-1894
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Country | US
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Telephone | 603-824-5570
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | MD19973
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | 44830
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | 20613
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License Number State | NH
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Taxonomy #4
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | MD61314277
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License Number State | WA
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