Active NPI
Richard L. Dickson
Doing business as Sol Duc Clinic
- Rural Health Clinic/Center
- Forks, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rural Health Clinic/Center
- Legal business name
- RICHARD L. DICKSON
- Doing business as
- Sol Duc Clinic
- Practice address
- 481 West E St
Forks, WA 98331 - Phone
- (360) 374-6642
- Fax
- (360) 374-5335
- NPI assigned
- Oct 9, 2007
- Last updated
- Feb 13, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Richard L Dickson, MD
- Title
- Owner Physician
- Phone
- (360) 374-6642
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | WA | Primary |
Addresses
Primary practice location
481 West E St
Forks, WA 98331
Mailing address
PO Box 1918
Forks, WA 98331
Phone (360) 374-6642
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7079999 | Medicaid | WA | |
| 59570 | Other | WA | DEPT OF L I |
Other names 1
- Sol Duc Clinic
National Provider Directory
National Provider Directory- Tax ID family
- Richard L Dickson
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Medicine Physician
- Forks, WA
- NPI 1760455075
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191888000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1202860800000",
"number": "1720276207",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1918",
"city": "FORKS",
"state": "WA",
"postal_code": "98331",
"telephone_number": "360-374-6642",
"fax_number": "360-374-5335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "481 WEST E ST",
"city": "FORKS",
"state": "WA",
"postal_code": "98331",
"telephone_number": "360-374-6642",
"fax_number": "360-374-5335"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RICHARD L. DICKSON",
"organizational_subpart": "NO",
"enumeration_date": "2007-10-09",
"last_updated": "2008-02-13",
"status": "A",
"authorized_official_last_name": "DICKSON",
"authorized_official_first_name": "RICHARD",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "OWNER PHYSICIAN",
"authorized_official_telephone_number": "360-374-6642",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "261QR1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rural Health",
"state": "WA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7079999",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT OF L I",
"identifier": "59570",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Sol Duc Clinic",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Forks, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.