Individual
KEN VICKERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1601 E 4TH PLAIN BLVD, VANCOUVER, WA 98661-3713
(503) 229-8262
Mailing address
1601 E 4TH PLAIN BLVD, VANCOUVER, WA 98661-3713
(502) 220-8262
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L6532
OR
Other
Enumeration date
03/27/2019
Last updated
03/27/2019
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