Individual
TODD MICHAEL WILLCOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5005 MAIN ST STE 125, TACOMA, WA 98407-3177
(253) 759-4522
(360) 598-7505
Mailing address
5005 MAIN ST STE 125, TACOMA, WA 98407-3177
(253) 759-4522
(360) 598-7505
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
MD00042148
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0251801
STATE L&I
WA
01
—
0261603
STATE L&I
WA
01
—
0266417
STATE L&I
WA
05
—
1009933
—
WA
01
—
198792
DEPT OF LABOR & INDUSTRY
WA
Enumeration date
12/06/2005
Last updated
01/18/2021
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