Individual
DR. DOUGLAS K. HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1217 NE BURNSIDE RD, BUILDING B, SUITE 401, GRESHAM, OR 97030-6722
(503) 666-8832
(503) 669-8641
Mailing address
PO BOX 82819, PORTLAND, OR 97282-0819
(503) 233-5405
(503) 233-2696
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
624
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164936
—
OR
Enumeration date
09/29/2006
Last updated
07/08/2007
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