Provider Demographics
NPI:1851392765
Name:ALLEN-KISSICK, HILLARY BROOKS (MD)
Entity Type:Individual
Prefix:DR
First Name:HILLARY
Middle Name:BROOKS
Last Name:ALLEN-KISSICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 STATE AVE NE STE 101
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-1170
Mailing Address - Country:US
Mailing Address - Phone:833-411-5469
Mailing Address - Fax:
Practice Address - Street 1:510 STATE AVE NE STE 101
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-1170
Practice Address - Country:US
Practice Address - Phone:833-411-5469
Practice Address - Fax:855-459-3020
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00042781207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8379935Medicaid
WA8808775Medicare ID - Type Unspecified
WAH98706Medicare UPIN