Individual
JOSHUA WICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
380 CHASE AVE, WALLA WALLA, WA 99362-2924
(509) 522-5820
Mailing address
PO BOX 32, LIBERTY LAKE, WA 99019-0032
(866) 747-2455
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
05/21/2015
Last updated
05/21/2015
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