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Individual

CHRISTINE CAROLE HICKS

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
RPH

Contact information

Practice address
1152 BASELINE, CORNELIUS, OR 97113-9019
(503) 352-8553
(503) 352-8554
Mailing address
8855 SW BRABHAM WAY, GASTON, OR 97119-9025
(503) 985-0140

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
PH00017057
WA
183500000X
Pharmacist
Primary
RPH-0009911
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PH00017057
PHARMACIST LICENSE
WA
01
RPH-0009911
PHARMACIST LICENSE
OR
Enumeration date
06/06/2006
Last updated
07/08/2007
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  • EDI platform