Individual
MISS KIRRA RACHEL HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.T.
Contact information
Practice address
7424 BRIDGEPORT WAY W STE 101, LAKEWOOD, WA 98499
(253) 582-8142
Mailing address
PO BOX 645441 LOCKBOX 005441, CINCINNATI, OH 45264-0001
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
43610
CA
225100000X
Physical Therapist
Primary
PT60688010
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2071776
—
WA
Enumeration date
01/15/2016
Last updated
09/27/2019
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