Individual
MRS. JILL MARIE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
220 W 1ST ST, ABERDEEN, WA 98520-6216
(360) 533-3853
(360) 533-3310
Mailing address
220 W 1ST ST, ABERDEEN, WA 98520-6216
(360) 533-3853
(360) 533-3310
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00007716
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0150618
LABOR AND INDUSTRIES
WA
01
—
2354WI
REGENCE BLUE SHIELD
WA
05
—
8333452
—
WA
Enumeration date
08/05/2006
Last updated
07/08/2007
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