Individual
RICHARD WICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
401 W POPLAR ST, WALLA WALLA, WA 99362-2846
(509) 522-5174
Mailing address
PO BOX 94645, SEATTLE, WA 98124-6945
(509) 474-2072
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD60629016
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/06/2012
Last updated
07/25/2016
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