Individual
MARCHELLE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2690 SR 903, CLE ELUM, WA 98922
(509) 649-4707
(509) 649-3634
Mailing address
2690 SR 903, CLE ELUM, WA 98922
(509) 649-4707
(509) 649-3634
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
OC60100676
WA
Other
Enumeration date
02/27/2013
Last updated
02/27/2013
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