Individual
JEFFREY TODD WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7943 HARGIS ST NW, OLYMPIA, WA 98502-9645
(360) 480-1410
Mailing address
7943 HARGIS ST NW, OLYMPIA, WA 98502-9645
(360) 480-1410
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
00002628
WA
Other
Enumeration date
01/26/2022
Last updated
01/26/2022
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