Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | MD00024026 | WA |
NPI | 1144273731 |
---|---|
Provider Name | Lee R. Hickok |
First Address | Seattle, WA 98104-1306 |
Second Address | Seattle, WA 98104-1306 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A09282 | (02) | WA |