Individual
LAURICE SAMUEL VICKERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1001 KLICKITAT WAY SW, SUITE 205 PSIP, SEATTLE, WA 98134
(206) 622-7747
(206) 467-1470
Mailing address
PO BOX 34245, PSIP, SEATTLE, WA 98124-1245
(206) 622-7747
(206) 467-1470
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
13323
WA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
14782
OR
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
5586
AK
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
C42192
CA
Other
Enumeration date
07/08/2006
Last updated
08/04/2010
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