Organization
RICHARD L. DICKSON
Active
Other names
Sol Duc Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD L DICKSON MD (OWNER PHYSICIAN)
(360) 374-6642
Entity
Organization
Contact information
Practice address
481 WEST E ST, FORKS, WA 98331
(360) 374-6642
(360) 374-5335
Mailing address
PO BOX 1918, FORKS, WA 98331
(360) 374-6642
(360) 374-5335
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
59570
DEPT OF L I
WA
05
—
7079999
—
WA
Enumeration date
10/09/2007
Last updated
02/13/2008
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