Search › Washington › 1041C0700X
Gary Fredericksen, LICSW
NPI 1700950557 · on the registry since 2006 · sole proprietor
Practice
- Address
- 4422 6th Ave Se
Lacey, WA 98503 - Phone
- (360) 704-7170
- Fax
- (360) 412-4982
- Organisation at this address
- Kirks Drug Inc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 7
Registry record
- Primary taxonomy
- 1041C0700X
1041C0700X
- Also registered as
- 101YM0800X
- Licence states on file
- WA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2007-07-20
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Washington