Individual
MR. KEVIN SPENCER HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
700 NE 87TH AVE, VANCOUVER, WA 98664
(360) 397-3119
(360) 604-1755
Mailing address
700 NE 87TH AVE, VANCOUVER, WA 98664-1913
(360) 397-3119
(360) 604-1755
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60088481
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8541625
—
WA
Enumeration date
05/31/2007
Last updated
08/06/2018
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