| Doctor Name: | LAURA JANE HICKERSON |
| NPI Number: | 1124171517 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RC |
| License Number: | RC00049296 |
| Business Practice Address: | 6100 Southcenter Blvd Tukwila, WA - 981882441 |
| Business Phone Number: | 2063022816 |
| Business Fax Number: | |
| Mailing Address: | 1600 E Olive St, Seattle Mental Health SEATTLE |
| State: | WA |
| Postal Code: | 981222735 |
| Phone Number: | 2063022200 |
| Fax Number: | 2063022210 |
| NPI Enumeration Date: | 01/19/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | RC00049296 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |