Individual
CHARLES L. WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5402 47TH AVE NE, SEATTLE, WA 98105-2927
(206) 525-4090
(206) 985-2875
Mailing address
5402 47TH AVE NE, SEATTLE, WA 98105-2927
(206) 525-4090
(206) 985-2875
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD00016624
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7062144
—
WA
Enumeration date
10/23/2006
Last updated
06/25/2021
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