Active NPI
Amber Olivia Hickman, L.M.P.
- Specialist
- Newcastle, WA
National Provider Identifier
1336439769
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 00014408
- Practice address
- 6965 Coal Creek Pkwy SE
Newcastle, WA 98059-3136 - Phone
- (425) 641-7765
- NPI assigned
- Apr 19, 2011
- Last updated
- Apr 19, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 00014408 | WA | Primary |
Addresses
Primary practice location
6965 Coal Creek Pkwy SE
Newcastle, WA 98059-3136
Mailing address
13710 2ND Ave NW
Seattle, WA 98177-3918
Phone (206) 405-0393
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00014408 | WA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303171200000",
"number": "1336439769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13710 2ND AVE NW",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981773918",
"telephone_number": "206-405-0393",
"fax_number": "206-286-8958"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6965 COAL CREEK PKWY SE",
"city": "NEWCASTLE",
"state": "WA",
"postal_code": "980593136",
"telephone_number": "425-641-7765"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKMAN",
"first_name": "AMBER",
"middle_name": "OLIVIA",
"name_prefix": "Mrs.",
"credential": "L.M.P.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-04-19",
"last_updated": "2011-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "00014408",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newcastle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.