Individual
JESSICA LYNN HICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
107 1ST ST N, YELM, WA 98597-7718
(360) 458-1900
Mailing address
PO BOX 476, YELM, WA 98597-0476
(360) 458-1900
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP00042684
WA
Other
Enumeration date
02/27/2018
Last updated
02/27/2018
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