Individual
DESIREE HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
19240 AURORA AVE N, 2-408, SHORELINE, WA 98133-2934
(406) 591-8847
Mailing address
19240 AURORA AVE N, 2-408, SHORELINE, WA 98133-2934
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60724983
WA
Other
Enumeration date
02/13/2017
Last updated
02/13/2017
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