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General NPI Number Information
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NPI Number | 1629089396
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Entity Type | Individual
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Provider Name | VERONICA MARIE HICKS PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 12/06/2022
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Provider Practice Location Address
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Address Line | 1205 N 10TH ST STE A
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City | RENTON
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State | WA
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Zip | 98057-5577
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Country | US
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Telephone | 425-690-3474
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Fax | 425-690-9475
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Provider Business Mailing Address
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Address Line | 1129 23RD AVE S APT 202
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City | SEATTLE
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State | WA
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Zip | 98144-2961
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Country | US
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Telephone | 206-328-4438
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA10004943
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA10004943
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License Number State | WA
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