Individual
MRS. JILL MARIE WILSON
Active
Individual
MRS. JILL MARIE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
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
Update your record
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