Individual
JACQUELINE CORA RICKLICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4609 BRIGGS DR SE, APT 304, OLYMPIA, WA 98501-5515
(360) 349-3344
Mailing address
4609 BRIGGS DR SE, APT 304, OLYMPIA, WA 98501-5515
(360) 349-3344
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN.LP.00040788
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
164W00000X
LPN
WA
Enumeration date
06/20/2016
Last updated
06/20/2016
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