Individual
MARK SIKORA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5107 BOULDER WAY, YAKIMA, WA 98901-1618
(509) 966-7953
Mailing address
5107 BOULDER WAY, YAKIMA, WA 98901-1618
(509) 966-7953
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LW00004500
WA
1041C0700X
Clinical Social Worker
LW00004500
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2029759
—
WA
Enumeration date
01/10/2007
Last updated
02/10/2014
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