Individual
MR. JONATHAN ELLIOTT HICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
3857 MARTIN WAY E, OLYMPIA, WA 98506-5268
(360) 704-7170
(360) 412-4982
Mailing address
3857 MARTIN WAY E, OLYMPIA, WA 98506-5268
(360) 704-7170
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
9284934
NH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP61398090
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3078870
—
NH
Enumeration date
04/10/2013
Last updated
03/20/2025
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