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Individual

KRISTI H TRICKETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
501 S 5TH AVE, YAKIMA, WA 98902-3550
(509) 574-6139
(509) 574-6138
Mailing address
501 S 5TH AVE, YAKIMA, WA 98902-3550
(509) 494-6700
(509) 573-6275

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
OL60660989
WA
207Q00000X
Family Medicine Physician
Primary
OP60775257
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0416855
LABOR AND INDUSTRIES
WA
05
2059448
WA
Enumeration date
05/24/2016
Last updated
01/13/2022
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