Provider Demographics
NPI:1609051689
Name:HORNICK, RICHARD (BS)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:
Last Name:HORNICK
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:RIK
Other - Middle Name:
Other - Last Name:HORNICK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1715 SE 32ND PL
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-5016
Mailing Address - Country:US
Mailing Address - Phone:503-777-2929
Mailing Address - Fax:
Practice Address - Street 1:1715 SE 32ND PL
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-5016
Practice Address - Country:US
Practice Address - Phone:503-777-2929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor