Individual
MR. RICHARD LEE DICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
481 W E ST, FORKS, WA 98331
(360) 374-6642
(360) 374-5335
Mailing address
PO BOX 1918, 481 W E ST, FORKS, WA 98331
(360) 374-6642
(360) 374-5335
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16829
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1641208
—
WA
Enumeration date
02/08/2006
Last updated
11/19/2010
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