Individual
HOLLY LYNN WICKIZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6160 S. COLUMBIAN WAY, SEATTLE, WA 98108
(206) 321-1907
Mailing address
8805 2ND AVE S, SEATTLE, WA 98108-4502
(206) 321-1907
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
13304
SC
1041C0700X
Clinical Social Worker
CG60771577
WA
Other
Enumeration date
09/25/2017
Last updated
06/26/2020
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