Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Samuel David Dickerson

Individual provider General Practice Physician · NPI 1801651765

Samuel David Dickerson is a General Practice Physician in Tacoma, Washington. Licensed in Virginia. Registered with an NPI since 2024.

Licensed in
VA
In the registry since
2024

Practice location Address checks out

9040 Jackson Ave
Tacoma, WA 98431-0001
Phone: (253) 968-1420
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X · Licence 0101288217 (VA)

Record details

NPI number1801651765
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedFebruary 19, 2024
Last updated in NPPESJanuary 28, 2026
Certification dateJanuary 28, 2026
Mailing address9040 Jackson Ave, Tacoma, WA 98431-0001

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