DR. JESS W. HICKERSON (NPI# 1629010996) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1629010996 |
Entity Type | Individual |
Full Name | DR. JESS W. HICKERSON |
Credential | M.D. |
Practice Address |
400 Nw Walnut Blvd Suite 300 Corvallis OR 97330-3874 |
Practice Telephone | 5417684680 |
Practice Fax Number | 5417684681 |
Mailing Telephone | 5417684680 |
Mailing Fax Number | 5417684681 |
Enumeration Date | 2006-06-12 |
Last Update Date | 2013-03-19 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
MD13896 | OR | Allopathic & Osteopathic Physicians |
Street Address |
400 NW WALNUT BLVD SUITE 300 |
City | CORVALLIS |
State | OR |
Zip Code | 97330-3874 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316212624 | Good Samaritan Hospital Corvallis | Obstetrics & Gynecology | 400 Nw Walnut Blvd, Suite 300, Corvallis, OR 97330-3874 | 2012-03-20 |
1639367311 | Willamette Orthotics & Prosthetics LLC | Prosthetic/Orthotic Supplier | 400 Nw Walnut Blvd, Suite 100, Corvallis, OR 97330-3874 | 2007-10-09 |
1043321953 | Hanger Prosthetics & Orthotics West Inc | Durable Medical Equipment & Medical Supplies | 400 Nw Walnut Blvd, Suite 100, Corvallis, OR 97330-3874 | 2006-08-31 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235754912 | Miya Claborn | Counselor | 4495 Se Hwy 20, Corvallis, OR 97330 | 2020-06-09 |
1548889017 | Greydi Olvera | Counselor | Childrens Farm Home 4455 Ne Hwy 20, Corvallius, OR 97330 | 2020-04-14 |
1053953992 | Andie Marie Gaipo | Counselor | 4455 Ne Hwy 20 - Children's Farm Home, Corvallis, OR 97330 | 2019-10-11 |
1740847177 | Stephen Jack Eccles | Behavior Technician | Trillium Children's Farm Home, 4455 Ne Hwy 20, Corvallis, OR 97330 | 2019-05-21 |
1750944815 | Tiffany Rene Flinchpaugh | Counselor | Children's Farm Home 4455 Hwy 20, Corvallis, OR 97330 | 2019-04-15 |
1679035455 | Isaiah Mile Cassidy | Counselor | Children's Farm Home-4455 Ne Hwy 20, Corvallis, OR 97330 | 2019-04-02 |
1982168399 | Haylee Cramblit | Counselor | Children's Farm Home 4455 Ne Hwy 20, Corvallis, OR 97330 | 2019-01-30 |
1457835365 | Ashley Alyn Couch | Counselor | 4455 Hwy 20 Corvallis 97330, Corvallis, OR 97330 | 2018-09-18 |
1104318898 | Megan Gerding | Technician, Other | 996 Nw Circle Blvd Suite 103, Corvallis, OR 97330 | 2018-05-30 |
1700377108 | Pacific Hearing Services | Audiologist | 975 Nw Spruce Ave, Suite #101, Corvallis, OR 97330 | 2018-05-22 |
Find all providers in zip 97330 |
Taxonomy Code | 207VG0400X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Obstetrics & Gynecology |
Specialization | Gynecology |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255751160 | Cynthia A Noble Md PC | Obstetrics & Gynecology | 2298 Nw Kings Blvd, Corvallis, OR 97330-3923 | 2014-04-17 |
1477597250 | Glenn S. Huerta-enochian | Obstetrics & Gynecology | 3680 Nw Samaritan Dr, Corvallis, OR 97330-3737 | 2006-06-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780141804 | Amybrunermd LLC | Obstetrics & Gynecology | 6958 Sw Varns Street, Portland, OR 97223 | 2019-02-25 |
1649775610 | Asma S. Ahmad, Md, LLC | Obstetrics & Gynecology | 4160 Sw Charming Way, Portland, OR 97225-2025 | 2018-03-29 |
1780021899 | Grapevine Womens Health and Gynecology, LLC | Obstetrics & Gynecology | 5880 Ne Cornell Rd Ste C, Hillsboro, OR 97124-9075 | 2013-05-30 |
1861717290 | Richard Malcolm Thorne | Obstetrics & Gynecology | 1295 Victoria Falls Dr, Redmond, OR 97756-8287 | 2010-03-29 |
1194975078 | Mid-columbia Medical Center | Obstetrics & Gynecology | 1730 E. 12th St, The Dalles, OR 97058 | 2008-09-26 |
1477729754 | Lithia Women's Healthcare LLC | Obstetrics & Gynecology | 725 N. Main St., Ashland, OR 97520-1752 | 2008-05-06 |
1164695953 | Leonard Laskow | Obstetrics & Gynecology | 1939 Tamarack Pl, Ashland, OR 97520-3542 | 2008-04-11 |
1164600243 | Northwest Gynecology Associates,llc | Obstetrics & Gynecology | 4660 Ne Belknap Ct Ste 109, Hillsboro, OR 97124-8402 | 2008-01-31 |
1033323613 | Laila Raad Sillay | Obstetrics & Gynecology | 9555 Sw Barnes Rd Ste 360, Portland, OR 97225-6617 | 2007-05-10 |
1528181625 | Emily Christina Culbert | Obstetrics & Gynecology | 4626 Se Salmon St, Portland, OR 97215-2542 | 2007-04-06 |
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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.