Provider Demographics
NPI:1720098973
Name:KRICK, GEORGE H (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:H
Last Name:KRICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 S 19TH ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-2962
Mailing Address - Country:US
Mailing Address - Phone:253-572-3520
Mailing Address - Fax:253-627-9842
Practice Address - Street 1:1901 SO CEDAR
Practice Address - Street 2:SUITE 202
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405
Practice Address - Country:US
Practice Address - Phone:253-572-3520
Practice Address - Fax:253-627-9842
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00015419207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1137603Medicaid
A08484Medicare UPIN
WAG001000607Medicare ID - Type Unspecified