Individual
HOLLY WILDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11000 LAKE CITY WAY NE, SEATTLE, WA 98125
(206) 545-2320
(206) 634-3596
Mailing address
11000 LAKE CITY WAY NE, SEATTLE, WA 98125-6748
(206) 545-2320
(206) 634-3596
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
MC60871044
WA
390200000X
Student in an Organized Health Care Education/Training Program
MC60871044
WA
Other
Enumeration date
10/24/2016
Last updated
03/29/2019
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