Organization
NORTHWEST KETAMINE CLINICS TACOMA, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALLYN D WILCOCK ARNP (OWNER)
(206) 330-6722
Entity
Organization
Contact information
Practice address
1901 S UNION AVE, BUILDING B, SUITE 4001, TACOMA, WA 98405
(206) 309-2299
(425) 256-3250
Mailing address
35302 SE CENTER ST, SNOQUALMIE, WA 98065-9216
(206) 330-6722
(425) 256-3250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/27/2021
Last updated
01/27/2021
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