Hickerson, Thomas H

Hickerson, Thomas H is an individual health care provider with primary practice located at 14450 Se Royer Rd , Clackamas OR 97015-8730. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Hickerson, Thomas H can be contacted via phone (503) 658-5521.

Contact Information

Primary practice address
14450 Se Royer Rd Clackamas OR 97015-8730
Phone: (503) 658-5521
Fax: (503) 658-5002
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD10999 Oregon

Profile Details

NPI number 1700840675
LBN Legal business name Hickerson, Thomas H
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 17th, 2006
Last updated Aug 9th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700840675 NPPES
Washington MEDICAID 8438574
Washington MEDICAID 240325

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