Individual
ANDREW STEPHEN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
9040 JACKSON AVENUE, JOINT BASE LEWIS MCCHORD, WA 98431-4504
(253) 968-1100
(253) 968-0100
Mailing address
9040 JACKSON AVENUE, JOINT BASE LEWIS MCCHORD, WA 98431-0001
(253) 968-1100
(253) 968-0100
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0102205803
VA
207RC0000X
Cardiovascular Disease Physician
DO228356
OR
207RC0000X
Cardiovascular Disease Physician
OP70055223
WA
207RI0011X
Interventional Cardiology Physician
Primary
U9389
TX
Other
Enumeration date
03/22/2018
Last updated
01/28/2026
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