Individual
CAROL ELLEN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, MSN
Contact information
Practice address
205 8TH ST, HOQUIAM, WA 98550-2507
(360) 236-5328
Mailing address
713 THRASHER AVE NE, NORTH BEND, WA 98045-7919
(425) 888-0110
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
RN00086590
WA
163W00000X
Registered Nurse
Primary
RN00086590
WA
163WP0808X
Psychiatric/Mental Health Registered Nurse
RN00086590
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0216286
NATIONAL CERTIFICATION IN PSYCHIATRIC AND MENTAL HEALTH NURSING
—
01
—
RN00086590
RN
WA
01
—
WAC 3888650150
MENTAL HEALTH PROFESSIONAL BY MENTAL HEALTH DIVISION OF WA STATE
WA
Enumeration date
08/25/2015
Last updated
11/30/2022
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