Organization
RICHARD L DICKSON, M.D.
Active
Other names
Sol Duc Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD LEE DICKSON M.D. (PHYSICIAN/OWNER)
(360) 374-6642
Entity
Organization
Contact information
Practice address
481 WEST E. ST., FORKS, WA 98331-1918
(360) 374-6642
(360) 374-5335
Mailing address
PO BOX 1918, FORKS, WA 98331-1918
(360) 374-6642
(360) 374-5335
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
600372068
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
59570
DEPT OF L & I
WA
05
—
7075542
—
WA
Enumeration date
08/13/2007
Last updated
09/10/2008
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