Individual
DR. HEATHER S TICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4225 ROOSEVELT WAY NE, SEATTLE, WA 98105-6099
(206) 616-2877
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 543-6420
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD60262938
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0296299
L&I
WA
05
—
1215079470
—
WA
Enumeration date
02/13/2007
Last updated
11/29/2012
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