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Individual
DR. ADAM SPACH WILSON
Active
Individual
DR. ADAM SPACH WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD00034230
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011826007
REGENCE BLUE CROSS OF OR
OR
01
—
0130871
WA DEPT OF LABOR & INDUST
WA
01
—
300151208
REGENCE HMOO
OR
05
—
8197287
—
WA
01
—
98683A007
TRIWEST
WA
Enumeration date
03/23/2006
Last updated
07/08/2007
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