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Individual

DR. JOEL R WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1135-116TH AVENUE NE, BELLEVUE, WA 98004
(425) 454-2656
(425) 455-2620
Mailing address
PO BOX 3047, MS 315010, SEATTLE, WA 98124-3947
(425) 454-2656
(425) 455-2620

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
A122356
CA
207RC0000X
Cardiovascular Disease Physician
D0070298
MD
207RC0000X
Cardiovascular Disease Physician
Primary
MD00046763
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8457921
WA
Enumeration date
07/22/2006
Last updated
03/21/2017
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