Individual
MARY M. WILCOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1708 YAKIMA AVE, TACOMA, WA 98405-5307
(253) 596-3339
Mailing address
PO BOX 34584, SEATTLE, WA 98124-1584
(509) 241-7349
(509) 241-7628
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN00141664
WA
363LA2200X
Adult Health Nurse Practitioner
Primary
AP30007015
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9647975
—
WA
Enumeration date
01/16/2007
Last updated
06/22/2021
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