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Individual

DR. MARK AARON WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
19020 33RD AVE W STE 210, LYNNWOOD, WA 98036-4748
(425) 563-1500
(425) 563-1501
Mailing address
19020 33RD AVE W STE 210, LYNNWOOD, WA 98036-4748
(425) 563-1500
(425) 563-1374

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
M-12272
ID
2085R0202X
Diagnostic Radiology Physician
MD00048678
WA
2085R0204X
Vascular & Interventional Radiology Physician
M-12272
ID
2085R0204X
Vascular & Interventional Radiology Physician
Primary
MD00048678
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0224089
L&I-EVERGREEN RADIA
WA
01
0263398
L&I-RADIA REST OF WA
WA
01
0384223
L&I-RADIA KING COUNTY
WA
01
0384226
L&I-SWEDISH RADIA EDMONDS
WA
05
1255442737
ID
05
2007508
WA
Enumeration date
08/31/2006
Last updated
02/20/2019
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