Most Relevant Information
Provider Data
| NPI Number: | 1003244948 |
| Provider Name: | JESSICA KICHA MA |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: | MC60338137 |
Most Important Dates
| Enumeration Date: | 10/30/2013 |
| Last Updated: | 10/13/2015 |
Provider Practice Location
1400 112TH AVE SE
SUITE 100
BELLEVUE
WA
980046901
Practice Location Phone/Fax
| Phone: | 4252434722 |
| Fax: |
Provider Mailing Location
906 W. 2ND AVE., STE 100
NORTHWEST REGISTERED AGENT, LLC.
SPOKANE
WA
992017684
Provider Mailing Phone/Fax
| Phone: | 4257866192 |
| Fax: |