Basic Information
Provider Information
NPI: 1841426970
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHICK
FirstName: CAMERON
MiddleName: WOODWARD
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 510 8TH AVE NE STE 320
Address2:  
City: ISSAQUAH
State: WA
PostalCode: 980295436
CountryCode: US
TelephoneNumber: 4254553600
FaxNumber: 4254553920
Practice Location
Address1: 1231 116TH AVE NE STE 750
Address2:  
City: BELLEVUE
State: WA
PostalCode: 98004
CountryCode: US
TelephoneNumber: 4254553600
FaxNumber: 4254553920
Other Information
ProviderEnumerationDate: 06/03/2009
LastUpdateDate: 10/15/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000XMD60552138WAN Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 
207XS0106XMD60552138WAY Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery

ID Information
IDTypeStateIssuerDescription
204671905WA MEDICAID


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