Individual
MRS. EMILY ELAINE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, BA
Contact information
Practice address
400 CRATER LAKE AVE, MEDFORD, OR 97504-6808
(541) 613-6505
Mailing address
560 SHERIDAN ST, ASHLAND, OR 97520-1572
(206) 604-1476
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
249267
OR
225X00000X
Occupational Therapist
OT60089348
WA
Other
Enumeration date
06/15/2009
Last updated
04/01/2019
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