Provider Demographics
NPI:1871390922
Name:SICKELS, MARTINA K (MENTAL HEATH ASSOCC)
Entity type:Individual
Prefix:MRS
First Name:MARTINA
Middle Name:K
Last Name:SICKELS
Suffix:
Gender:
Credentials:MENTAL HEATH ASSOCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3513 BITTERSWEET ST SE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-5096
Mailing Address - Country:US
Mailing Address - Phone:151-235-7016
Mailing Address - Fax:
Practice Address - Street 1:3513 BITTERSWEET ST SE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-5096
Practice Address - Country:US
Practice Address - Phone:151-235-7016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61572210101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health