Vickers, Lisa A

Vickers, Lisa A is an sole proprietor health care provider with primary practice located at 1450 N 16Th Ave Ste 102 , Yakima WA 98902-1381. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Vickers, Lisa A can be contacted via phone (509) 249-0105.

Contact Information

Primary practice address
1450 N 16Th Ave Ste 102 Yakima WA 98902-1381
Fax: (509) 249-0035
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X AP30007200 Washington

Profile Details

NPI number 1851474704
LBN Legal business name Vickers, Lisa A
Credentials ARNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 23rd, 2006
Last updated Jul 28th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851474704 NPPES
Washington MEDICAID 9647793

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