Individual
KERRY HICKETHIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA, ATC
Contact information
Practice address
4200 6TH AVE SE, SUITE 203, LACEY, WA 98503-1042
(360) 455-4448
Mailing address
8137 SWEETBRIER LN SE, J-104, LACEY, WA 98513-8408
(360) 259-7729
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
8449
OR
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
04/13/2007
Last updated
09/11/2025
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