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Individual

WALLACE WILKINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
901 BOREN AVE STE 1300, SEATTLE, WA 98104-3509
(206) 284-1943
Mailing address
620 TERRY AVE UNIT 1907, SEATTLE, WA 98104-2284
(206) 284-1943
(206) 284-1943

Taxonomy

Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
1454
WA
103TB0200X
Cognitive & Behavioral Psychologist
1454
WA
103TC0700X
Clinical Psychologist
Primary
1454
WA

Other

Enumeration date
11/09/2006
Last updated
11/17/2022
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