Individual
PATRICIA ANNE WILBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
1820 BLACK LAKE BLVD SW, #103, OLYMPIA, WA 98512-5619
(360) 584-3889
Mailing address
P.O. BOX 15142, TUMWATER, WA 98511-5142
(360) 584-3889
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00025187
WA
Other
Enumeration date
01/28/2008
Last updated
01/28/2008
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