Individual
WILLIAM KELLY WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1660 S COLUMBIAN WAY, S-112, SEATTLE, WA 98108-1532
(206) 277-6464
Mailing address
233 SW 154TH ST, #103, BURIEN, WA 98166-2351
(206) 277-6464
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
10/17/2012
Last updated
10/17/2012
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