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Individual
SUZANNE M WILSON
Active
Individual
SUZANNE M WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO00000472
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1098623
—
WA
Enumeration date
09/30/2005
Last updated
03/22/2017
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