DR. STANLEY MICHAEL HICKS (NPI# 1336129451) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336129451 |
| Entity Type | Individual |
| Full Name | DR. STANLEY MICHAEL HICKS |
| Credential | M.D. |
| Practice Address |
700 Lincoln St Suite 100 Kelso WA 98626-1057 |
| Practice Telephone | 3604255131 |
| Mailing Telephone | 3604255131 |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
MD00029538 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 8136988 | 05 | |
| WA | LABOR & INDUSTRIES | 34871 | 01 |
| OR | OREGON DSHS | 040803 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679062889 | Stanley D. Hicks | Pharmacist | 1626 Highway 12 S, Ashland City, TN 37015-3322 | 2018-05-02 |
| Street Address |
700 LINCOLN ST SUITE 100 |
| City | KELSO |
| State | WA |
| Zip Code | 98626-1057 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255311288 | Tyler Douglass Gibb | Radiology | 700 Lincoln St, Suite 100, Kelso, WA 98626-1057 | 2006-01-17 |
| 1467473363 | Nicole Francoise Bolender | Radiology | 700 Lincoln St, Suite 100, Kelso, WA 98626-1072 | 2006-07-23 |
| 1205880713 | Longview Radiologists, P.s. Inc. | Radiology | 700 Lincoln St, Suite 100, Kelso, WA 98626-1057 | 2006-05-20 |
| 1437139045 | Robert Eugene Ehrlich | Radiology | 700 Lincoln St, Suite 100, Kelso, WA 98626-1057 | 2006-01-19 |
| 1447230255 | Hasan Tuna Ozgur | Radiology | 700 Lincoln St, Suite 100, Kelso, WA 98626-1057 | 2006-01-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730581877 | Wrothell Funchess | Counselor | 1645 Bowmont Ave, Kelso, WA 98626 | 2014-09-19 |
| 1427457688 | Julie Dalen | Counselor | 309 Oak Street, Kelso, WA 98626 | 2014-08-13 |
| 1033468822 | Rene Kerry Bohannon-oxford | Counselor | 2707 Pacific Ave North, Kelso, WA 98626 | 2012-09-07 |
| 1447535737 | Nichole Kathleen Allee | Massage Therapist | 109 Nw 1st St., Kelso, WA 98626 | 2011-10-18 |
| 1689991655 | Zachariah Kramer | Radiology | 700 Lincoln Street Suite 100, Longview Radiologists, Kelso, WA 98626 | 2010-04-29 |
| 1508007071 | Robert Lee Blair | Registered Nurse | 119 Blackburn Lane, Kalama, WA 98626 | 2009-03-13 |
| 1942318829 | Imholte & Anderson Pllc | Dentist | 409 West Main Street, Kelso, WA 98626 | 2006-08-29 |
| 1922088723 | James Bevan Hollingsworth | Pharmacist | 204 S Pacific Ave, Kelso, WA 98626 | 2006-01-18 |
| 1972021087 | Adreia Jenice Jessop | Registered Nurse | 300 Oak St, Kelso, WA 98626 | 2017-09-08 |
| 1023567310 | Charlene Han | Pharmacist | 205 Three Rivers Dr, Kelso, WA 98626 | 2016-09-27 |
| Find all providers in zip 98626 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497999262 | Fatma Berk | Radiology | 700 Lincoln St Ste 100, Kelso, WA 98626-1062 | 2009-04-23 |
| 1255311288 | Tyler Douglass Gibb | Radiology | 700 Lincoln St, Suite 100, Kelso, WA 98626-1057 | 2006-01-17 |
| 1053547620 | Michael J Pawlik | Radiology | 700 Lincoln St Ste 100, Kelso, WA 98626-1062 | 2009-06-09 |
| 1205880713 | Longview Radiologists, P.s. Inc. | Radiology | 700 Lincoln St, Suite 100, Kelso, WA 98626-1057 | 2006-05-20 |
| 1437139045 | Robert Eugene Ehrlich | Radiology | 700 Lincoln St, Suite 100, Kelso, WA 98626-1057 | 2006-01-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790325710 | Proliance Surgeons, Inc., P.s. | Radiology | 1101 Madison St Ste 580, Seattle, WA 98104-4305 | 2020-01-07 |
| 1447711544 | Ashkan Jonathan Ahmadian | Radiology | 1959 Ne Pacific Street Radiology Department Rr 210, Seattle, WA 98195-1019 | 2019-03-29 |
| 1639653017 | Radia Imaging Center Holdings LLC | Radiology | 1229 Madison St Ste 900, Seattle, WA 98104-1391 | 2018-09-20 |
| 1427546597 | Kiet Van Vo | Radiology | 1959 Ne Pacific St # 357115, Seattle, WA 98195-0001 | 2018-04-24 |
| 1730605965 | Bellingham Advanced Medical Imaging LLC | Radiology | 1344 King St Ste 101, Bellingham, WA 98229-6215 | 2017-08-18 |
| 1184140477 | Proliance Surgeons, Inc., P.s. | Radiology | 6808 220th St Sw Ste 105, Mountlake Terrace, WA 98043-2187 | 2017-08-17 |
| 1003367863 | Providence Health & Services Washington | Radiology | 4800 College St Se Ste E, Lacey, WA 98503-4389 | 2016-10-17 |
| 1861846057 | Ethan Hua | Radiology | Radiology Department Rr 210 1959 Ne Pacific, Seattle, WA 98195-0001 | 2016-04-14 |
| 1437537354 | Mahmood Albahhar | Radiology | 4245 Roosevelt Way Ne Box 354755, University of Washington Medical Center, Seattle, WA 98105 | 2015-05-12 |
| 1336533991 | Keegan Hovis | Radiology | 1959 Ne Pacific Street Radiology Department, Seattle, WA 98195-3358 | 2015-03-22 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.