# MS. HALLE L. WILSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1568532455
- **Gender:** F
- **Credential:** DPT, OCS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 4822 | OR | Yes |

## Other

- **Enumeration date:** 11/08/2006
- **Last updated:** 02/05/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0210754 | WA DEPT OF L & I | WA |
| 05 | — | 278293 | — | OR |
| 01 | — | 500746101 | REGENCE HMO | OR |
| 01 | — | 838969001 | REGENCE BCBS | OR |
| 01 | — | M103634 | PACIFIC SOURCE HEALTH PLA | OR |