Individual
BRIAN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
800 W 5TH AVE, SPOKANE, WA 99204
(509) 458-5800
Mailing address
340 N PENNSYLVANIA AVE, GREENSBURG, PA 15601-1827
(651) 829-0032
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
421116
OH
163W00000X
Registered Nurse
48568
MT
163W00000X
Registered Nurse
670677
PA
163W00000X
Registered Nurse
93880
WV
367500000X
Certified Registered Nurse Anesthetist
Primary
AP60824089
WA
Other
Enumeration date
09/22/2017
Last updated
06/25/2018
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