Provider Demographics
NPI:1689679144
Name:BICKEL, ALAN WYCHE (MD)
Entity Type:Individual
Prefix:MR
First Name:ALAN
Middle Name:WYCHE
Last Name:BICKEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 560825
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80256-0825
Mailing Address - Country:US
Mailing Address - Phone:719-595-7580
Mailing Address - Fax:719-545-0176
Practice Address - Street 1:8614 E MILL PLAIN BLVD STE 201
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-2058
Practice Address - Country:US
Practice Address - Phone:360-729-8580
Practice Address - Fax:360-729-8599
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO32469174400000X
WAMD61509301208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01324698Medicaid
CO340017456OtherRAIL ROAD MEDICARE
CO340017456OtherRAIL ROAD MEDICARE
COB65133Medicare UPIN
CO547992YK2DMedicare PIN