Individual
MAXWELL WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
200 TRIANGLE CENTER #270, LONGVIEW, WA 98632-2367
(360) 501-3750
(360) 501-3755
Mailing address
1615 DELAWARE ST, LONGVIEW, WA 98632-2367
(360) 414-2000
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
61642856
WA
Other
Enumeration date
11/24/2025
Last updated
01/23/2026
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