| Organization Name: | RICHARD L. DICKSON |
| NPI Number: | 1720276207 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RICHARD L DICKSON (OWNER PHYSICIAN) |
| Mailing Address: | 481 West E St Forks |
| State: | WA US |
| Postal Code: | 98331 |
| Phone Number: | 3603746642 |
| Fax Number: | 3603745335 |
| NPI Enumeration Date: | 10/09/2007 |
| NPI Last Update Date: | 02/13/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |