Individual
KRISTINA ANN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA60186404
Contact information
Practice address
3209 E 57TH AVE, SUITE F, SPOKANE, WA 99223
(509) 448-9398
(509) 232-5777
Mailing address
5729 S FERRALL ST, SPOKANE, WA 99223
(509) 448-3411
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MA 60186404
WA
Other
Enumeration date
01/21/2011
Last updated
01/21/2011
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