Individual
MR. PAUL DANIEL FICKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
724 S CENTRAL AVE STE 101, MEDFORD, OR 97501-7808
(541) 789-4222
Mailing address
724 S CENTRAL AVE STE 101, MEDFORD, OR 97501-7808
(541) 249-7244
(541) 325-4055
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
201805705NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201805705NP-PP
OREGON STATE BOARD OF NURSING
OR
Enumeration date
02/15/2018
Last updated
08/20/2021
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