Provider Demographics
NPI:1013946466
Name:BOWEN-HICKS, NANCY M (MS CCC-A)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:M
Last Name:BOWEN-HICKS
Suffix:
Gender:F
Credentials:MS CCC-A
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:M
Other - Last Name:BOWEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS CCC-A
Mailing Address - Street 1:333 SE 7TH AVE
Mailing Address - Street 2:SUITE 4150
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-4157
Mailing Address - Country:US
Mailing Address - Phone:503-352-2661
Mailing Address - Fax:503-924-6704
Practice Address - Street 1:333 SE 7TH AVE
Practice Address - Street 2:SUITE 4150
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4157
Practice Address - Country:US
Practice Address - Phone:503-352-2661
Practice Address - Fax:503-924-6704
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA20544231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR028096Medicaid
OR028096Medicaid