Individual
MR. JOHN MATTHEW WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CCC-SLP
Contact information
Practice address
3517 NORFOLK CT SE, OLYMPIA, WA 98501-7021
(360) 705-1107
(360) 357-5900
Mailing address
3517 NORFOLK CT SE, OLYMPIA, WA 98501-7021
(360) 705-1107
(360) 357-5900
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL00002640
WA
Other
Enumeration date
09/18/2012
Last updated
09/18/2012
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