Provider Demographics
NPI:1508816703
Name:MICHAEL HICKEN, MD, PC
Entity Type:Organization
Organization Name:MICHAEL HICKEN, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:POWEL
Authorized Official - Last Name:HICKEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-615-0960
Mailing Address - Street 1:5880 NE CORNELL RD
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-9075
Mailing Address - Country:US
Mailing Address - Phone:503-615-0960
Mailing Address - Fax:503-615-8572
Practice Address - Street 1:5880 NE CORNELL RD
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-9075
Practice Address - Country:US
Practice Address - Phone:503-615-0960
Practice Address - Fax:503-615-8572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty