Individual
KIRSTEN ELIZABETH WICKSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
325 9TH AVE, SEATTLE, WA 98104-2420
(206) 520-5000
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 520-5700
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN60465203
WA
363LF0000X
Family Nurse Practitioner
Primary
AP61166029
WA
Other
Enumeration date
03/05/2020
Last updated
07/27/2023
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