Individual
MR. RICHARD MARK WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1660 S COLUMBIAN WAY, SEATTLE, WA 98108-1532
(206) 764-2134
Mailing address
1660 S COLUMBIAN WAY, SEATTLE, WA 98108-1532
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP30004637
WA
Other
Enumeration date
01/17/2008
Last updated
01/17/2008
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