| Doctor Name: | DR. RICHARD A. WYCKOFF |
| NPI Number: | 1235235896 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PHD |
| License Number: | PY00003316 |
| Business Practice Address: | 17311 135th Ave Ne B-800 Woodinville, WA - 980723519 |
| Business Phone Number: | 4257650475 |
| Business Fax Number: | |
| Mailing Address: | 8215 Ne 124th St, KIRKLAND |
| State: | WA |
| Postal Code: | 980342539 |
| Phone Number: | 4258215230 |
| Fax Number: | |
| NPI Enumeration Date: | 09/14/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PY00003316 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | WA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |