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General NPI Number Information
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NPI Number | 1609645977
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Entity Type | Individual
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Provider Name | DEVON HICKAM DC
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Gender | Male
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Dates
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Enumeration Date | 12/27/2023
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Last Update Date | 12/27/2023
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Provider Practice Location Address
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Address Line | 915 E HAWTHORNE RD
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City | SPOKANE
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State | WA
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Zip | 99218-1482
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Country | US
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Telephone | 509-413-2302
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Fax |
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Provider Business Mailing Address
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Address Line | 6447 TIMBER DR
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City | NINE MILE FALLS
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State | WA
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Zip | 99026-9559
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Country | US
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Telephone | 509-789-0157
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 61491400
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License Number State | WA
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