Individual
MARY KATHLEEN SHICKICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
210 W GALER ST, SEATTLE, WA 98119-3332
(206) 586-8390
(206) 895-4792
Mailing address
210 W GALER ST, SEATTLE, WA 98119-3332
(206) 586-8390
(206) 895-4792
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD60875348
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669835807
—
WA
Enumeration date
04/04/2016
Last updated
01/09/2024
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