Individual
LEKISHA WILDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
325 E PIONEER, PUYALLUP, WA 98372-3265
(253) 697-8400
Mailing address
325 E PIONEER, PUYALLUP, WA 98372-3265
(253) 697-8400
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
61015997
WA
Other
Enumeration date
01/08/2020
Last updated
02/18/2020
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