Healthcare Provider Details

I. General information

NPI: 1982402624
Provider Name (Legal Business Name): KRISTY J HICKMAN SLPA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2025
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 E CENTRAL AVE
SPOKANE WA
99208-1108
US

IV. Provider business mailing address

5924 W 14TH CT
KENNEWICK WA
99338-1402
US

V. Phone/Fax

Practice location:
  • Phone: 866-240-0809
  • Fax:
Mailing address:
  • Phone: 509-551-3181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSP61583236
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-06-2700
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: