Individual
ALLYN D. WILCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
7829 CENTER BLVE STE 310, SNOQUALMIE, WA 98065
(206) 330-6722
(425) 256-3250
Mailing address
36410 SE ISLEY ST, SNOQUALMIE, WA 98065-8983
(206) 330-6722
(425) 256-3250
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN00157281
WA
367500000X
Certified Registered Nurse Anesthetist
Primary
AP30006926
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0197111
LABOR & INDUSTRY
WA
01
—
52822U
REGENCE BLUESHIELD
WA
01
—
8940597
L & I CRIME VICTIMS
WA
05
—
9644782
—
WA
Enumeration date
04/06/2006
Last updated
02/14/2017
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