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Individual
DR. SHAWN H WILSON
Active
Individual
DR. SHAWN H WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OP00002116
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
212148
LABOR & INDUSTRIES - YAKIMA LOCATION
WA
01
—
4141WI
BLUESHIELD - YAKIMA LOCATION
WA
05
—
8461048
—
WA
01
—
P00339532
RAILROAD MEDICARE
WA
Enumeration date
08/05/2006
Last updated
06/30/2010
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