Individual
MR. WILSON PERSHING STEVENSON III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3250 PORT OF BENTON BLVD STE D, RICHLAND, WA 99354-1670
(509) 371-2570
(866) 880-2576
Mailing address
3250 PORT OF BENTON BLVD STE D, RICHLAND, WA 99354-1670
(509) 371-2570
(866) 880-2576
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
601942637
WA
Other
Enumeration date
04/16/2018
Last updated
04/16/2018
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