Individual
LISA A VICKERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1450 N 16TH AVE STE 102, YAKIMA, WA 98902-1381
(509) 249-0105
(509) 249-0035
Mailing address
1450 N 16TH AVE STE 102, YAKIMA, WA 98902-1381
(509) 249-0105
(509) 249-0035
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP30007200
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9647793
—
WA
Enumeration date
10/23/2006
Last updated
07/28/2014
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