Organization
WILSON CLINICAL SERVICES, PLLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAIME A B WILSON PH.D., ABPP, MSCP (PRESCRIBING MEDICAL PSYCHOLOGIST)
(253) 200-0255
Entity
Organization
Contact information
Practice address
1117 A ST, TACOMA, WA 98402-5003
(360) 339-7752
Mailing address
1117 A ST, TACOMA, WA 98402-5003
(360) 339-7752
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
—
—
103TC0700X
Clinical Psychologist
—
—
103TP0016X
Prescribing (Medical) Psychologist
Primary
—
—
251S00000X
Community/Behavioral Health Agency
602937457
WA
Other
Enumeration date
07/31/2009
Last updated
02/09/2023
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