Individual
JENNIFER MARIE WICKENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1200 E COLUMBIA AVE, COLVILLE, WA 99114-3354
(509) 684-3701
(509) 684-5817
Mailing address
POB 31001-4114, PASADENA, CA 91110-4114
(509) 747-2455
(509) 944-9644
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ML61481130
WA
Other
Enumeration date
04/07/2022
Last updated
06/24/2025
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