Andrew Jason Hickman
Individual provider Active NPI Massage Therapist · Middleton, ID
NPI 1053259689 · NPPES record last updated Mar 24, 2026
Key facts
- NPI
- 1053259689
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 1671284 (ID)
- Practice address
- 1032 Millwood Ave
Middleton, ID 83644-3008 - Phone
- (208) 365-8746
- NPI assigned
- Mar 24, 2026
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1671284 | ID | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 1671284 | ID | Yes |
Addresses
Primary practice location
1032 Millwood Ave
Middleton, ID 83644-3008
Mailing address
1032 Millwood Ave
Middleton, ID 83644-3008
Phone (208) 365-8746
Other providers in Middleton, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 24, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.