MEDICARE: DR. HILLARY BROOKS ALLEN-KISSICK M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MD00042781	WA

General Provider Information

NPI Number	:	1851392765
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HILLARY BROOKS ALLEN-KISSICK M.D.

Provider Business Mailing Address
First Line	:	510 STATE AVE NE STE 101
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98501-1170
Country	:	US
Telephone Number	:	833-411-5469
Fax Number	:

Provider Business Practice Location Address
First Line	:	510 STATE AVE NE STE 101
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98501-1170
Country	:	US
Telephone Number	:	833-411-5469
Fax Number	:	855-459-3020

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	07/06/2023

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