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Individual

MARY ELIZABETH MICIKAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
515 MINOR AVE STE 170, SEATTLE, WA 98104
(206) 386-9500
(206) 386-9605
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(206) 320-4476
(206) 568-7043

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN60800561
WA
363L00000X
Nurse Practitioner
Primary
AP60801941
WA
363LF0000X
Family Nurse Practitioner
AP60801941
WA

Other

Enumeration date
10/26/2017
Last updated
06/29/2018
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