Douglas K. Hicks, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

624 Issued in OR

Practice address

1217 NE Burnside Rd
Building B, Suite 401
Gresham, OR 97030-6722

Phone

(503) 666-8832

Fax

(503) 669-8641

NPI assigned

Sep 29, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Western Psychological and Counseling Services LLC

  • Clinical Psychologist
  • Vancouver, WA
  • NPI 1629345731
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245322601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 82819",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972820819",
            "telephone_number": "503-233-5405",
            "fax_number": "503-233-2696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 NE BURNSIDE RD",
            "address_2": "BUILDING B, SUITE 401",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970306722",
            "telephone_number": "503-666-8832",
            "fax_number": "503-669-8641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "DOUGLAS",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164936",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Toni Loraine Hero, D.O.
• Herrhythm Acupuncture and Reproductive Wellness, LLC
• Traci Heward, MSW
• Evan C Hiatt, CADCR/CRM/PSS/QMHA-R
• Maryellen Hibbard, FNP
• Michelle Hicks
• Cheryl Higgins, LMT
• Lelisa Hika
• Christopher James Hill, LMFT
• Matthew J Hill

• Clinical Psychologist in Gresham, OR
• Providers in Gresham, OR by specialty
• Clinical Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.