Individual
DR. MARIAREGINA LANDICHO WICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
NAVAL HEALTH CLINIC OAK HARBOR 3475 NO SARATOGA ST, OAK HARBOR, WA 98278-0001
(360) 257-9501
(360) 257-9978
Mailing address
NAVAL HEALTH CLINIC OAK HARBOR 3475 NO SARATOGA ST, OAK HARBOR, WA 98278-0001
(360) 257-9501
(360) 257-9978
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
00023369
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00023369
WA MD LICENSE
WA
01
—
170322
LABOR AND INDUSTRIES ID
WA
01
—
7116841
DSHS (PAYABLE GROUP)
WA
05
—
8176398
—
WA
01
—
E47294
MEDICARE UPIN
WA
01
—
GAB38763
MEDICARE PIN (PTAN)
WA
Enumeration date
11/01/2006
Last updated
08/29/2022
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